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Changes in functional connectivity in people with HIV switching antiretroviral therapy

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posted on 2023-06-07, 07:13 authored by Sofia Toniolo, Mara Cercignani, Borja Mora-Peris, Jonathan Underwood, Jasmini Alagaratnam, Marco Bozzali, Marta Boffito, Mark Nelson, Alan Winston, Jaime Vera RojasJaime Vera Rojas
We assessed changes in functional connectivity by fMRI (functional magnetic resonance imaging) and cognitive measures in otherwise neurologically asymptomatic people with HIV (PWH) switching combination antiretroviral therapy (cART). In a prospective study (baseline and follow-up after at least 4 months), virologically suppressed PWH switched non-nuclease reverse-transcriptase inhibitors (NNRTI; tenofovir-DF/emtricitabine with efavirenz to rilpivirine) and integrase-strand-transfer inhibitors (INSTI; tenofovir-DF/emtricitabine with raltegravir to dolutegravir). PWH were assessed by resting-state fMRI and stop-signal reaction time (SSRT) task fMRI as well as with a cognitive battery (CogState™) at baseline and follow-up. Switching from efavirenz to rilpivirine (n?=?10) was associated with increased functional connectivity in the dorsal attention network (DAN) and a reduction in SSRTs (p?=?0.025) that positively correlated with the time previously on efavirenz (mean?=?4.8 years, p?=?0.02). Switching from raltegravir to dolutegravir (n?=?12) was associated with increased connectivity in the left DAN and bilateral sensory-motor and associative visual networks. In the NNRTI study, significant improvements in the cognitive domains of executive function, working memory and speed of visual processing were observed, whereas no significant changes in cognitive function were observed in the INSTI study. Changes in fMRI are evident in PWH without perceived neuropsychiatric complaints switching cART. fMRI may be a useful tool in assisting to elucidate the underlying pathogenic mechanisms of cART-related neuropsychiatric effects.

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Publication status

  • Published

File Version

  • Published version

Journal

Journal of NeuroVirology

ISSN

1355-0284

Publisher

Taylor & Francis

Department affiliated with

  • Global Health and Infection Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2020-06-09

First Open Access (FOA) Date

2020-06-09

First Compliant Deposit (FCD) Date

2020-06-09

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