Journal
JOURNAL OF NEUROVIROLOGY
Volume 18, Issue 4, Pages 291-302Publisher
SPRINGER
DOI: 10.1007/s13365-012-0114-1
Keywords
Aging; HIV; MRI; PET; Neuroimaging
Categories
Funding
- NCRR NIH HHS [G12 RR003061] Funding Source: Medline
- NIDA NIH HHS [K24 DA016170, R01 DA035659, R24 DA027318] Funding Source: Medline
- NIMH NIH HHS [R01 MH061427] Funding Source: Medline
- NINDS NIH HHS [U54 NS056883] Funding Source: Medline
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Highly active antiretroviral therapy (HAART) has increased life expectancy among HIV-infected individuals, and by 2015, at least half of all HIV-infected individuals will be over 50 years of age. Neurodegenerative processes associated with aging may be facilitated by HIV-1 infection, resulting in premature brain aging. This review will highlight brain abnormalities in HIV patients in the setting of aging, focusing on recent neuroimaging studies of the structural, physiological, functional and neurochemical changes. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy studies performed during the pre-HAART era or on antiretroviral-naive subjects suggest an accelerated aging process, while those on HAART-treated subjects suggest premature brain atrophy. Diffusion tensor imaging studies yielded conflicting findings on the relationship between HIV and age in neuroasymptomatic individuals. Functional MRI studies found evidence of premature or accelerated aging processes in the brains of HIV subjects. Lastly, many age-related illnesses such as diabetes, stroke, and depression, as well as comorbid substance abuse, may further exacerbate the aging process in the HIV-infected brain, leading to premature or accelerated age-related brain changes. Given the different pathologic or physiologic changes in the brain assessed by the different neuroimaging techniques, using a multimodal approach in longitudinal follow-up studies is recommended for future studies.
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