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首页> 外文期刊>Medicine. >White Matter Microstructural Integrity and Neurobehavioral Outcome of HIV-Exposed Uninfected Neonates
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White Matter Microstructural Integrity and Neurobehavioral Outcome of HIV-Exposed Uninfected Neonates

机译：HIV暴露的未感染新生儿的白色物质微结构完整性和神经行为结果

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The successful implementation of prevention programs for mother-to-child human immunodeficiency virus (HIV) transmission has dramatically reduced the prevalence of infants infected with HIV while increasing that of HIV-exposed uninfected (HEU) children. Neuropsychological assessments indicate that HEU children may exhibit differences in neurodevelopment compared to unexposed children (HUU). Pathological mechanisms leading to such neurodevelopmental delays are not clear. In this observational birth cohort study we explored the integrity of regional white matter microstructure in HEU infants, shortly after birth. Microstructural changes in white matter associated with prenatal HIV exposure were evaluated in HEU infants (n?=?15) and matched controls (n?=?22) using diffusion tensor imaging and tract-based spatial statistics. Additionally, diffusion values were extracted and compared for white matter tracts of interest, and associations with clinical outcomes from the Dubowitz neonatal neurobehavioral tool were investigated. Higher fractional anisotropy in the middle cerebellar peduncles of HEU compared to HUU neonates was found after correction for age and gender. Scores on the Dubowitz abnormal neurological signs subscale were positively correlated with FA (r?=?0.58, P?=?0.038) in the left uncinate fasciculus in HEU infants. This is the first study to present data suggesting that prenatal HIV exposure without infection is associated with altered white matter microstructural integrity in the neonatal period. Longitudinal studies of HEU infants as their brains mature are necessary to understand further the significance of prenatal HIV and antiretroviral treatment exposure on white matter integrity and neurodevelopmental outcomes.
机译：成功实施母婴人类免疫缺陷病毒（HIV）传播预防计划，已大大降低了感染HIV的婴儿的患病率，同时增加了暴露于HIV的未感染（HEU）儿童的患病率。神经心理学评估表明，与未接触儿童（HUU）相比，HEU儿童可能表现出神经发育差异。导致这种神经发育延迟的病理机制尚不清楚。在这项观察性出生队列研究中，我们探讨了出生后不久HEU婴儿中区域白质微观结构的完整性。使用弥散张量成像和基于道的空间统计学方法，评估了HEU婴儿（n = 15）和匹配的对照组（n = 22）中与产前HIV暴露相关的白质的微结构变化。此外，提取扩散值并比较感兴趣的白质区域，并研究Dubowitz新生儿神经行为工具与临床结果的关联。校正年龄和性别后，与HUU新生儿相比，HEU小脑中部小花梗的分数各向异性更高。 HEU婴儿左束状筋膜中Dubowitz异常神经系统异常症状量表的得分与FA呈正相关（r？=？0.58，P？=？0.038）。这是第一项提出数据的研究，表明在新生儿期未感染的产前HIV暴露与新生儿白质微结构完整性的改变有关。为了进一步了解产前HIV和抗逆转录病毒治疗暴露对白质完整性和神经发育结局的重要性，必须对HEU婴儿的大脑进行纵向研究。

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