Brain alterations within the first 100 days of HIV infection

Ann B. Ragin*, Ying Wu, Yi Gao, Sheila Keating, Hongyan Du, Christina Sammet, Casey S. Kettering, Leon G. Epstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


Objective: Brain involvement is a serious complication of HIV infection. The earliest changes in the brain, which represents an anatomic site for viral persistence, are largely unknown. Methods: This investigation used quantitative Magnetic Resonance methodologies, including high resolution and diffusion tensor (DTI) imaging, to evaluate the brain in 15 HIV and 20 seronegative subjects. All HIV subjects were antibody nonreactive with assay-estimated infection duration of less than 100 days. Results: Brain volumetric analysis revealed reduced parenchyma with enlargement of the third ventricle and brainstem. DTI quantified loss of white matter integrity in the corpus callosum and diffusion alterations in caudate. Cognitive differences were indicated in psychomotor speed and visual recall. There were no differences between antiretroviral-initiated and naïve HIV subgroups. Interpretation: These findings, quantified within 100 days of infection, shed light on the earliest brain changes in HIV infection. Onset of neural injury may date to initial viral invasion and the transient early period of unchecked viremia and marked immunosuppression of the seroconversion period.

Original languageEnglish (US)
Pages (from-to)12-21
Number of pages10
JournalAnnals of clinical and translational neurology
Issue number1
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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