Effect of HIV and Interpersonal Trauma on Cortical Thickness, Cognition, and Daily Functioning.

BACKGROUND: Interpersonal trauma (IPT) is highly prevalent among HIV-positive (HIV+) individuals but its relationship with brain morphology and function is poorly understood.

SETTING: This cross-sectional analysis evaluated the associations of IPT with cognitive task performance, daily functioning, MRI brain cortical thickness and bilateral volumes of four selected basal ganglia (BG) regions in a US-based cohort of aviremic HIV+ individuals, with (HIV+IPT+) and without IPT exposure (HIV+IPT-), and socio-demographically matched HIV-negative controls with (HIV-IPT+) and without IPT exposure (HIV-IPT-).

METHODS: Enrollees completed brain MRI scans, a semi-structured psychiatric interview, a neurocognitive battery, and three measures of daily functioning. Demographic and clinical characteristics of the four groups were described, and pairwise between-group comparisons performed using chi-square tests, ANOVA, or t-tests. Linear or Poisson regressions evaluated relationships between group status and the outcomes of interest, in 6 pairwise comparisons, using Bonferroni correction for statistical significance.

RESULTS: Among 187 participants (mean age 50.0 years, 63% male, 64% non-White), 102 were HIV+IPT+, 35 HIV+IPT-, 26 HIV-IPT-, and 24 were HIV-IPT+. Compared to the remaining three groups, the HIV+IPT+ group had more Activities of Daily Living declines, higher number of impaired Patient's Assessment of Own Functioning Inventory scores, and lower cortical thickness in multiple cerebral regions. Attention/working memory test performances were significantly better in HIV-IPT- compared to HIV+IPT+ and HIV+IPT- groups. BG MRI volumes were not significantly different in any between-group comparisons.

CONCLUSION: IPT exposure and HIV infection have a synergistic effect on daily functioning and cortical thickness in aviremic HIV+ individuals.