CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

disorder (37 with Mild Neurocognitive Disorder, 1 with dementia), and 5 were considered cognitively normal. ROI analysis revealed positive correlations between MCP-1 and MD in the CC, bilateral anterior and superior CR, and left SLF, and between neopterin and MD in the genu of CC (p<0.05). Negative correlations existed between MCP-1 and FA in the CC, and between sCD14 and FA in the bilateral superior CR (p<0.05). Voxelwise analysis detected areas of direct correlation between MCP-1 and MD (p<0.05). Lower FA in parts of the CC, CR, and SLF directly correlated with worse neuropsychological performance globally and in the executive domain, and increased MD in the CC and left superior CR directly correlated with lower global neuropsychological scores (p<0.05). Conclusion: In virally suppressed HIV+ elders, inflammatory markers correlate with worse metrics of brain white matter injury. These metrics predict poorer cognitive performance, supporting the hypothesis that inflammation persisting despite viral suppression impacts brain integrity and may contribute to cognitive impairment in the cART era. 456 WHITE MATTER HYPERINTENSITIES INCREASE AS A FUNCTION OF CVD RISK AND HIV DISEASE Minjie Wu 1 , Shaolin Yang 2 , Hoby Hetherington 1 , Tae Kim 1 , Jeffry Alger 3 , Peter B. Barker 4 , Todd B. Parrish 5 , Andrew Levine 3 , Eileen Martin 6 , Cynthia Munro 4 , Ann B. Ragin 5 , Ned Sacktor 4 , Eric C. Seaberg 4 , James T. Becker 1 , for the Neuropsychology Working Group of the Multicenter AIDS Cohort Study 1 University of Pittsburgh, Pittsburgh, PA, USA, 2 University of Illinois at Chicago, Chicago, IL, USA, 3 University of California Los Angeles, Los Angeles, CA, USA, 4 Johns Hopkins University, Baltimore, MD, USA, 5 Northwestern University, Chicago, IL, USA, 6 Rush University Medical Center, Chicago, IL, USA Background: White Matter Hyperintensities (WMH) are a marker of cerebral small vessel disease. We have previously shown that HIV infection and diabetes mellitus interact to increase the volume of WMHs. The purpose of the present study was to evaluate the rate of change of WMH volume over a four year follow-up. Methods: 119 men from the MACS MRI subsidy contributed data: 43 uninfected and 76 with HIV Disease. There were no differences between the infected and uninfected men in the rates of diabetes, hypertension, Caucasian race, or syndrome depression. A greater proportion of the infected men were enrolled after 2000. 16% of the infected men had had an AIDS-defining illness. Cerebral WM and cerebellumWMmasks were created using both T1wMPRAGE and T2w FLAIR images using unified multispectral segmentation/normalization procedure in SPM12. Given the observation that there were very few lesions in the cerebellum in our patients, the mean and standard deviation of the cerebellar WM was used to Z-transform the T2w FLAIR image (Z-T2w FLAIR). On the Z-T2w FLAIR images, voxels greater or equal than 2 and within the cerebral WMmask were identified white matter lesions in the brain. WMH volume was expressed as the ratio between WMH and total WM. The dependent variable was the rate of change ((T2-T1)/T1)/year Results: First, we replicated and extended our cross-sectional data (Wu, et al., 2018) by finding that the annualized rate of change in WMH volume was elevated only among the HIV-infected men with diabetes (See Figure). The rate of change was virtually identical among the uninfected men and those with HIV Disease but not diabetes. Second, although we did not find a relationship between hypertension and WMHs in the cross-sectional analysis, this was not true as we tracked change over time. The normotensive, uninfected men had no change in their WMH volume over time. By contrast, the men with hypertension had a nearly 30% annual increase in WMH volume. The normotensive, infected men had a rate of change that was almost as high (20%) as that of the hypertensive men, and greater than that of the normotensive, uninfected me. Conclusion: These data emphasize the importance of cerebrovascular risk in the brain health of men with HIV Disease. The presence of infection acts to increase the rate of change of WMH as a function of hypertension and diabetes - even though these conditions were treated. Abnormal levels of WMHs reduce brain reserve capacity and increase risk of expressing cognitive impairment.

Poster Abstracts

457 RESTING-STATE CONNECTIVITY ASSOCIATES WITH DEPRESSION SYMPTOMS IN ACUTE HIV Carissa L. Philippi 1 , Leah Reyna 1 , Phillip Chan 2 , Nittaya Phanuphak 2 ,

Nisakorn Ratnaratorn 2 , Joanna Hellmuth 3 , Khunthalee Benjapornpong 2 , Netsiri Dumrongpisutikul 4 , Mantana Pothisri 4 , Jintanat Ananworanich 5 , Serena S. Spudich 6 , Victor Valcour 3 , Robert Paul 1 , for the SEARCH 010/RV254 and RV304/ SEARCH 013 study teams 1 University of Missouri St Louis, St Louis, MO, USA, 2 Thai Red Cross AIDS Research Center, Bangkok, Thailand, 3 University of California San Francisco, San Francisco, CA, USA, 4 Chulalongkorn University, Bangkok, Thailand, 5 US Military HIV Research Program, Bethesda, MD, USA, 6 Yale University, New Haven, CT, USA Background: The prevalence of depression symptoms in HIV can be relatively high and has been associated with increased morbidity and mortality. Previous research has revealed that HIV-related biological factors (e.g., CD4 count) are related to depressive symptoms in acute HIV (AHI). However, it is unclear whether neurobiological measures are also correlated with depression symptoms in AHI. The purpose of this study was to determine whether resting-state functional connectivity (rsFC, i.e., correlations in spontaneous low frequency fluctuations in brain activity) of anterior cingulate cortex (ACC) regions implicated in depression was associated with depression symptoms or anxiety and distress in AHI. Methods: Thai participants with AHI (n=74) and uninfected controls (CO; n=30) underwent resting-state functional magnetic resonance imaging. Seed-based voxelwise rsFC was computed for 3 ACC seed regions of interest (ROIs) implicated in depression. T-tests were performed to compare rsFC of ACC seed ROIs for AHI versus CO groups. Within the AHI group, we conducted voxelwise regression analyses to examine the relationship between depression symptoms, anxiety, and distress and rsFC for the ACC seed ROIs. All significant rsFC findings were family-wise error (FWE) corrected at the whole brain level, pFWE<0.017. Results: The AHI group had a mean (SD) CD4 count of 395 (±209) cells/uL, 6.03 (±1.1) log10 copies HIV RNA and estimated duration of infection of 19.0 (±6.6) days. There were no differences in rsFC of ACC for AHI versus CO groups. Within the AHI group, greater depression symptoms were associated with increased rsFC of ACC seeds with lateral and medial prefrontal regions as well as cerebellum (pFWE<0.017; Fig. 1). Greater depression symptoms were also related to decreased rsFC of ACC regions with precuneus/posterior cingulate cortex, ventral temporal and lateral parietal regions (pFWE<0.017; Fig. 1). Anxiety symptoms and distress were unrelated to rsFC of ACC. Only HIV RNA was

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