Cortical atrophy and white matter hyperintensities in HIV: the Hawaii Aging with HIV Cohort Study.

Background As many human immunodeficiency virus (HIV)-seropositive individuals are now living longer after infection because of highly active antiretroviral therapy, aging-related manifestations of cerebral small-vessel ischemic vascular disease, such as brain white matter hyperintensities (WMHs), are becoming increasingly important in this population. Goals This study was designed to determine the relationship between WMHs and cortical volumes in HIV-seropositive individuals. Materials and Methods Voxel-based morphometry was used to compare cortical volumes among 62 HIV-seropositive individuals participating in the Hawaii Aging with HIV Cohort Study, 30 with moderate WMHs and 32 with minimal or no WMHs. Results Presence of moderate WMHs was associated with decreased cortical volumes in the frontal lobes bilaterally. Conclusion These findings suggest that age-related WMHs are associated with reduced frontal gray matter volumes in HIV-seropositive individuals, supporting the hypothesis that the frontal lobes may have greater susceptibility to the effects of small-vessel ischemic vascular disease.