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4400 Low CD4 nadir linked to widespread cortical thinning in adults with HIV

Published online by Cambridge University Press:  29 July 2020

Shiva Hassanzadeh-Behbahani
Affiliation:
Georgetown - Howard Universities
Kyle F. Shattuck
Affiliation:
Georgetown - Howard Universities
Margarita Bronshteyn
Affiliation:
Georgetown - Howard Universities
Matthew Dawson
Affiliation:
Georgetown - Howard Universities
Monica Diaz
Affiliation:
Georgetown - Howard Universities
Princy Kumar
Affiliation:
Georgetown - Howard Universities
David J. Moore
Affiliation:
Georgetown - Howard Universities
Ronald J. Ellis
Affiliation:
Georgetown - Howard Universities
Xiong Jiang
Affiliation:
Georgetown - Howard Universities
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Abstract

OBJECTIVES/GOALS: The history of immune suppression, especially CD4 nadir, has been shown to be a strong predictor of HIV-associated neurocognitive disorders (HAND). However, the potential mechanism of this association is not well understood. This study examined the relationship between CD4 nadir and brain atrophy. METHODS/STUDY POPULATION: Fifty-nine people with HIV participated in the cross-sectional study (mean age, 56.5 ± 5.8; age range, 41-69; 15 females; 46 African-Americans). High resolution structural MRI images were obtained using a 3T Siemens scanner. From a comprehensive 7-domain neuropsychological test battery, a global deficit score (GDS) and HAND diagnoses were determined for each participant. The correlation between CD4 nadir (the lowest ever lymphocyte CD4 count) and cortical thickness was investigated using a vertex-wise non-parametric approach with a conservative statistical threshold of p < 0.05 (FWE-corrected). RESULTS/ANTICIPATED RESULTS: Out of the 59 participants, 12 met standard Frascati criteria for asymptomatic neurocognitive impairment (ANI) and two met the criteria for mild neurocognitive disorder (MND). Across all participants, low CD4 nadir was associated with widespread cortical thinning, especially in the frontal and temporal regions. Higher GDS (indicating worse global neurocognitive function) was associated with bilateral frontal cortical thinning, and the association largely persisted in the subset of participants who did not meet HAND criteria. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that the low CD4 nadir may be associated with widespread neural injury in the brain, especially in the frontal and temporal regions. This spatial profile might contribute to the prevalence/phenotypes of HAND in the cART era, such as the frequently observed deficits in the executive domain.

Type
Basic Science/Methodology
Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Association for Clinical and Translational Science 2020

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4400 Low CD4 nadir linked to widespread cortical thinning in adults with HIV
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