Pre-clinical atherosclerosis is found at post-mortem, in the brains of men with HIV
Authors:
Daramola, Olusola Ali, Hebah Mckenzie, Chris Anne Smith, Colin Benjamin, Laura A. Solomon, Tom
Abstract:
The aim of this study is to ascertain the burden of pre-clinical atheroscleroticchanges in the brains of young adult males with HIV and explore the impact ofanti-retroviral therapy (ART). The study design is case-control, cross-sectional. Histological sections from HIV-positivepost-mortem brain samples, with no associated opportunistic infection, from theMRC Edinburgh brain bank were evaluated. These were age and sex matched with HIV-negativecontrols. Immunohistochemical stains were performed to evaluate characteristicsof atherosclerosis. The pathological changes were graded blinded to the HIVstatus and a second histopathologist reassessed 15%. Univariable models wereused for statistical analyses; p≤0.05 was considered significant.Nineteen HIV-positivepost-mortem cases fulfilled our inclusion criteria. Nineteen HIV-negativecontrols were selected. We assessed mostly small-to medium-sized vessels. For inflammation (CD45), 7 (36%) of the HIV+ had moderate/severe changes compared withnone for the HIV− group (p<0.001). Moderate/severeincrease in smooth muscle remodeling (SMA) was found in 8 (42%) HIV+ and 0 HIV− brains (p<0.001).Moderate/severe lipoprotein deposition (LOX-1) was found in 3 (15%) and 0 HIV−brains (p<0.001). ART was associated with less inflammation [5 (63%) noART versus 2 (18%) on ART (p=0.028)] but was not associatedwith reduced lipid deposition or smooth muscle damage. InHIV infection, there are pre-clinical small- to medium-sized vesselatherosclerotic changes and ART may have limited impact on these changes. Thiscould have implications on the increasing burden of cerebrovascular disease inHIV populations and warrants further investigation.
Journal:
Journal of NeuroVirology
Hyperlink:
Research Themes:
1. Patient Research for Public Health