Alcohol use may be associated with microstructural compromise to frontal white matter in patients infected with HIV who do not have dementia and who are undergoing antiretroviral therapy, according to new findings published in Alcoholism Clinical and Experimental Research.
Both HIV and alcohol use have been shown to exert a negative effect on the integrity of white matter pathways in the brain. Further, alcohol use disorder (AUD) is prevalent in the HIV–positive population. In this study, the authors examined the effect of alcohol use on the microstructural integrity of frontal white matter pathways among 37 individuals with HIV without dementia or hepatitis C co-infection.
A review of magnetic resonance imaging data revealed that the greatest degree of reduced axonal integrity, as measured by axial diffusivity along the anterior thalamic radiation (ATR), was observed in individuals with a history of AUDs. An AUD diagnosis explained 24.5% of the variance in ATR axial diffusivity, as well as 15.0% of the variance in ATR mean diffusivity, after adjusting for age differences, age-adjusted infection length, and severity (via Nadir CD4). A diagnosis of AUD explained 36.3% of the variance in all ATR diffusivity metrics.
“These results extend the past findings in this area and provide specific anatomical support to suggest that frontal white matter can be negatively affected in the least compromised HIV+ patients with alcohol use histories,” conclude the investigators.
Gullett JM, Lamb DG, et al. The impact of alcohol use on frontal white matter in HIV [published online June 29, 2018]. Alcohol Clin Exp Res. doi: 10.1111/acer.13823