Relève étoile Jacques-Genest 
June 2018

Ryan Sanford

PhD student in Biomedical Engineering
Montreal Neurological Institute/McGill University

Award-winning publication: Association of Brain Structure Changes and Cognitive Function With Combination Antiretroviral Therapy in HIV-Positive Individuals

Published in: JAMA Neurology


Human immunodeficiency virus (HIV) is a retrovirus that makes the immune system vulnerable to scores of opportunistic infections. But up to 50% of patients who respond well to treatment experience cognitive impairments. Studies on individuals suffering from advanced HIV who respond poorly to treatment suggest that the impairments may stem from ongoing brain injury. But researchers have yet to figure out whether this also applies to patients in whom treatment is effective. Ryan Sanford therefore set out to determine whether brain atrophy also progresses in patients who are receiving treatment. A total of 48 HIV-infected patients who respond well to treatment and 31 healthy subjects underwent MRI scans and cognitive tests at a two-year interval. While the HIV-infected patients had smaller brain volumes and posted less favourable cognitive test results as compared to the healthy individuals, the rates of change in brain volume and test performance were similar across the groups. In addition, patients' immunosuppression levels prior to treatment were negatively correlated with brain volume. These results suggest that treatment can prevent brain atrophy and that the impacts of HIV infection on the brain prior to treatment may be the cause of patients' cognitive impairments.