整合酶链转移抑制剂和依非韦伦对艾滋病毒阳性男男性行为者神经精神状况和脑成像的不同影响

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引用次数: 0

摘要

整合酶链转移抑制剂(INSTIs)因其卓越的疗效和安全性,已成为治疗人类免疫缺陷病毒(HIV)感染的一线选择。然而,由于数据有限,INSTIs 对艾滋病病毒感染者(PLWH)神经精神疾病发展的影响尚不完全清楚。在本研究中,我们对接受抗逆转录病毒治疗的艾滋病感染者进行了横断面检查,重点关注接受 INSTI 治疗方案(n = 61)和依非韦伦(EFV)治疗方案(n = 28)的艾滋病阳性男男性行为者(MSM)。参与者接受了全面的神经精神评估和多模态磁共振成像(MRI)扫描,包括T1加权图像和静息态功能磁共振成像。与 EFV 组相比,INSTI 组主要表现出右侧顶叶上回灰质体积(GMV)减少,左侧中央后回区域同质性(ReHo)提高,右侧额叶下回眶部 ReHo 降低,左侧颞下回种子区与右侧楔状回集群的体素功能连接性增强。此外,分析显示抗逆转录病毒药物对 GMV 变化有主效应,但神经精神疾病或它们之间的交互作用没有主效应。对未更换治疗方案的参与者进行的重复分析证实了 INSTI 组的 GMV 变化,从而验证了最初的研究结果。我们的研究表明,与使用 EFV 治疗方案的 PLWH 相比,使用 INSTI 治疗方案的 PLWH 脑灰质萎缩,脑功能发生变化。这些神经影像学结果为了解接受 INSTI 治疗方案的 PLWH 脑网络改变的特征提供了宝贵的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The differential effects of integrase strand transfer inhibitors and efavirenz on neuropsychiatric conditions and brain imaging in HIV-positive men who have sex with men

Integrase strand transfer inhibitors (INSTIs) have emerged as the first-line choice for treating human immunodeficiency virus (HIV) infection due to their superior efficacy and safety. However, the impact of INSTIs on the development of neuropsychiatric conditions in people living with HIV (PLWH) is not fully understood due to limited data. In this study, we conducted a cross-sectional examination of PLWH receiving antiretroviral therapy, with a specific focus on HIV-positive men who have sex with men (MSM) on INSTI-based regimens (n = 61) and efavirenz (EFV)-based regimens (n = 28). Participants underwent comprehensive neuropsychiatric evaluations and multimodal magnetic resonance imaging (MRI) scans, including T1-weighted images and resting-state functional MRI. Compared to the EFV group, the INSTI group exhibited primarily reduced gray matter volume (GMV) in the right superior parietal gyrus, higher regional homogeneity (ReHo) in the left postcentral gyrus, lower ReHo in the right orbital part of the inferior frontal gyrus, and increased voxel-wise functional connectivity for the seed region in the left inferior temporal gyrus with clusters in the right cuneus. Furthermore, the analysis revealed a main effect of antiretroviral drugs on GMV changes, but no main effect of neuropsychiatric disorders or their interaction. The repeated analysis of participants who did not switch regimens confirmed the GMV changes in the INSTI group, validating the initial findings. Our study demonstrated gray matter atrophy and functional brain changes in PLWH on INSTI-based regimens compared to those on EFV-based regimens. These neuroimaging results provide valuable insights into the characteristics of brain network modifications in PLWH receiving INSTI-based regimens.

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来源期刊
Biosafety and Health
Biosafety and Health Medicine-Infectious Diseases
CiteScore
7.60
自引率
0.00%
发文量
116
审稿时长
66 days
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