CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

396 RETINAL LAYERS THICKNESS AS MARKER OF ACCELERATED NEUROCOGNITIVE DECAY IN HIV DISEASE Chiara Resnati 1 , Alessandro Invernizzi 1 , Alessandra Acquistapace 1 , Marta Ferrari 1 , Sara Bochicchio 1 , Valentina Leta 1 , Cristina Gervasoni 2 , Stefano Rusconi 1 , Simone Pomati 2 , Agostino Riva 2 1 Univ of Milan, Milano, Italy, 2 Luigi Sacco Univ Hosp, Milano, Italy Background: Asymptomatic/mild HIV associated neurocognitive disorder, in the form of a premature cognitive and brain aging, is a concern despite effective ART. The retina can be considered an extension of the CNS, thus Spectral domain optical coherence tomography (SD-OCT) was used to investigate structural changes of retinal layers in subjects affected by brain diseases. The aim of this study was to investigate the structural changes occurring in different retinal layers visualized by SD-OCT in HIV patients with well controlled disease without retinitis. Methods: Methods We performed SD-OCT on 69 HIV positive patients on ART with VL<37 cp/ml. To rule out the presence of unknown ocular condition possibly affecting the data collection all subjects underwent a complete ophthalmic examination. SD-OCT images of the retina were collected in both eyes with Heidelberg Spectralis OCT. This technique allowed a detailed visualization of the retinal layers in the macular region, these scans were later used to analyze ganglion cells layer (GCL) and inner plexiform layer (IPL) of the retina. All the enrolled subjects underwent a Montreal Cognitive Assessment Test (MoCA). Results: Results 69 HIV positive patients (21 females,48 males) with well controlled disease (VL<37 cp/ml) with a mean age of 53 years (SD 7.3, range 41-70) were analyzed with 41 age and sex matched healthy controls. With aging Ganglion Cells Complex (GCL + IPL) thickness decreased significantly in HIV subjects (p=0.004) and also in healthy controls but without statistical significance. Splitting GCC into its components: GCL is the most significant layer(r=-0.37, p< 0.001) . GCL thickness did not show significant correlation with gender, disease duration, CD4 nadir, therapy with thymidine analogues. The score achieved in MoCA resulted significantly lower in HIV patients compared to controls (p=0.0008). Cognitive Function significantly decreased in HIV patients with age (Fig1); in controls a similar trend was evident with borderline significance (p=0.058). However, the correlation between age and MoCA Test resulted significant only in HIV subjects (p=0.0009). MoCA was directly correlated with GCL thickness in HIV patients (Fig 1), but was not in healthy controls. Conclusion: Conclusions Our results suggest premature cognitive impairment in HIV subjects. GCL thickness significantly decrease in HIV with ageing. Decline is similar to cognitive function decrease. GCL thickness could be an indirect marker for CNS premature ageing in HIV.

CROI 2017 160