CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

These subtle changes on neuroimaging were not captured using standard neuropsychological tests and suggest that neuroimaging may be important in the evaluation of sedentary PLWH. Future studies should evaluate the effects of exercise training or increasing physical activity on brain volumes in sedentary PLWH. 393 ACTIVE LIFESTYLE IS ASSOCIATED WITH BETTER BRAIN FUNCTION IN PERSONS LIVING WITH HIV Jeremy Strain 1 , Collin Killgore 1 , Dimitre Tomov 1 , Sarah A. Cooley 1 , Brittany Nelson 1 , Beau Ances 1 1 Washington University in St Louis, St Louis, MO, USA Background: Mortality due to HIV has dramatically reduced due to the introduction of combination anti-retroviral therapy (cART). Despite virologically suppression many PLWH still develop cognitive impairment can occur. On average, PLWH have reduced physical exertion and a reduction in active lifestyles. A reduction in physical function may affect both brain function and structure in PLWH. We evaluated whether physical fitness (as measured by VO2 maximum) relates to metrics of brain structure (diffusion tensor imaging (DTI)) and function (arterial transit time (ATT)). Methods: Forty-one sedentary elderly virologically well-controlled PLWH underwent neuroimaging (DTI and CBF). Each participant completed a graded exercise test on a cycle ergometer with 12-lead electrocardiography. Measurements of oxygen uptake, carbon dioxide production, heart rate, and blood pressure will be continuously monitored during testing to compute peak VO2. DTI fractional anisotropy (FA) was processed using tract-based spatial statistics FSL 5.0.9. CBF was processed with in-house scripts to calculate regional arterial transit time (ATT) that corresponds to how long the blood takes to perfuse into the brain tissue. ATT maps were registered to their corresponding T1 scan and regional volumes were extracted based on Freesurfer 5.3 parcellations. Partial correlations were performed between VO2 max and imaging metrics for both structure and function. Each correlation was adjusted for age and gender with a statistical threshold set at p<0.05. Results: FA was positively associated with VO2 max in the Frontal Aslant Tract, frontal occipital fasciculus, inferior longitudinal fasciculus and superior longitudinal fasciculus (Figure 1B). ATT positively associated with VO2 max in several gray matter regions that correspond to the white matter projections (Figure 1A). The strongest correlations were seen in the paracentral, posterior cingulate, and dorsal lateral prefrontal regions. Conclusion: We found that current fitness associated with both structure and function in an aviremic sedentary older PLWH. Higher VO2 max related to improved brain structure and function diversely throughout the cortex. Together, this bolsters the claim that physical fitness may improve brain integrity of virologically stable HIV participants.

4 Universidad Rey Juan Carlos, Madrid, Spain, 5 Hospital Universitario de Getafe, Madrid, Spain, 6 La Paz University Hospital, Madrid, Spain, 7 Hospital General Universitario Gregorio Marañón, Madrid, Spain Background: Brain atrophy has been observed in perinatally HIV-infected patients (PHIV) despite initiation on combined antiretroviral treatment (cART), but studies measuring cortical thickness (CT) are limited. We aimed to evaluate the neurologic state and CT of immunovirological stable PHIV youths with good daily functioning. Methods: A total of 25 PHIV patients on cART and 25 healthy controls (HC) matched by age, sex, level of education and socioeconomic status underwent a Magnetic Resonance Imaging scan. CAT12 toolbox was used to extract cortical thickness values from T1w images using parcellations from to two atlases (Human Connectome Project multi-modal parcellation (HCP-MMP1) and Desikan–Killiany atlas (DK40)). Mean thickness values for all ROIs in both atlases were compared between HIV+ and HC with a two-independent-samples t-test with age and gender as covariates. Neuropsychological assessments were conducted, which consist of fluid intelligence (FI) scale for overall functioning, and composite Z-score for executive functions (EFZ-10). Psychopathological symptoms were also obtained. Results: 50 participants were included (60% females, median age 20 years [IQR 19-23], 64% caucasian). Regarding PHIV: 40% had history of AIDS (3 had encephalopathy), median CD4% nadir 11.9% (IQR 5-17). At assessment, 84% had viral load <50 cp/ml (uVL), median viral load in detectable patients 416 cp/ ml (IQR 185-530), median CD4 687 cel/mm 3 (IQR 497-830), median time on cART 17.12 years (IQR 14.82-18.54) and median time with uVL 10.85 years (6.83-13.13). No significant differences regarding FI, EFZ-10 or psychopathological symptoms were found. When comparing CT, significant differences (p<0.05, Holm-Bonferroni corrected) were found using both atlases, where PHIV-infected patients showed thinner cortices compared with their non-HIV peers. According to HCP-MMP1, differences were found in left and right Ventral Visual Complexes and right Pirform cortex. Based on DK40, differences were located in left and right fusiform gyri, left and right lateral-orbitofrontal gyri and right parsobitalis gyrus. No significant differences were found in the opposite contrast (HIV+> HC). Conclusion: Despite good control of HIV infection and no differences in neurocognitive evaluation, PHIV showed thinner cortices of the temporal, orbito-frontal and occipital lobes. Longitudinally studies are required to determine the impact of HIV on brain in PHIV patients during adulthood.

Poster Abstracts

394 EFFECTS OF PERINATAL HIV INFECTION ON THE CORTICAL THICKNESS IN YOUNG ADULTHOOD Manuela Martín-Bejarano 1 , Beatriz Ruiz-Saez 2 , Ana Martinez De Aragon 3 , Carlos Velo 3 , Mario Gil-Correa 4 , Sara Guillen 5 , Maria Luisa Lorente 5 , Pablo Rojo Conejo 3 , Berta Zamora 3 , Talía Sainz 6 , José Tomás Ramos 1 , Juan Guzman 7 , Maria Luisa Navarro 7 , María Isabel González-Tomé 3 , for the NeuroCoRISpe 1 Hospital Universitario Clí¬nico San Carlos, Madrid, Spain, 2 Hospital Universitario Reina Sofia, Cordoba, Spain, 3 Hospital Universitario 12 de Octubre, Madrid, Spain,

395 EFFECT OF ANTICHOLINERGIC MEDICATIONS ON BRAIN INTEGRITY IN OLDER HIV-POSITIVE ADULTS Sarah A. Cooley 1 , Beau Ances 1 1 Washington University in St Louis, St Louis, MO, USA

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