ArticleNeurology2015
Brain arterial remodeling contribution to nonembolic brain infarcts in patients with HIV.
Article in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- HIV infection as vascular risk: A systematic review of the literature and meta-analysis.PloS one · 2017Pooled it
- The role of atherosclerosis in HIV-associated vasculopathy in young South African stroke patients.HIV medicine · 2025Article
- New Directions in Infection-Associated Ischemic Stroke.Journal of clinical neurology (Seoul, Korea) · 2024Review
- PLWH treated with modern ART and high CD4 T cell counts: no evidence of HIV-associated vasculopathy measured by extra- and intracranial ultrasound.Acta neurologica Belgica · 2024Article
- Biotypes of Central Nervous System Complications in People With Human Immunodeficiency Virus: Virology, Immunology, and Neuropathology.The Journal of infectious diseases · 2023Article
- Cerebrovascular Contributions to Neurocognitive Disorders in People Living With HIV.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Neuroimaging and Cognitive Evidence for Combined HIV-Alcohol Effects on the Central Nervous System: A Review.Alcoholism, clinical and experimental research · 2021Article
- Commentary - HIV-Induced Extracranial Carotid Ectasia and Stroke.Journal of AIDS and HIV treatment · 2021Article
- Role of Brain Arterial Remodeling in HIV-Associated Cerebrovascular Outcomes.Frontiers in neurology · 2021Review
- Review
- Extracranial ectasia and embolic infarcts in HIV: two case reports and a clinical decision-making algorithm.Journal of neurovirology · 2020Article
- TGF-β Signaling: A Therapeutic Target to Reinstate Regenerative Plasticity in Vascular Dementia?Aging and disease · 2020Review
- HIV and cardiovascular disease.The lancet. HIV · 2020Review
- Inflammation, Autoimmunity, Infection, and Stroke: Epidemiology and Lessons From Therapeutic Intervention.Stroke · 2020Review
- Predictors of Ischemic and Hemorrhagic Strokes Among People Living With HIV: The D:A:D International Prospective Multicohort Study.EClinicalMedicine · 2019Article
- Brain arterial dilatation and the risk of Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2019Article
- Article
- Relationship Between Brain Arterial Pathology and Neurocognitive Performance Among Individuals With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Brain vascular intima vulnerability among HIV-positive and negative individuals.AIDS (London, England) · 2018Article
- Brain Large Artery Lymphocytic Inflammation and Human Immunodeficiency Virus-Related Brain Arterial Remodeling.Journal of virology · 2018Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCerebrovascular disease is a cause of morbidity in HIV-infected populations. The relationship among HIV infection, brain arterial remodeling, and stroke is unclear.
methodsLarge brain arteries (n = 1,878 segments) from 284 brain donors with and without HIV were analyzed to obtain media and wall thickness and lumen-to-wall ratio, and to determine the presence of atherosclerosis and dolichoectasia (arterial remodeling extremes). Neuropathologic assessment was used to characterize brain infarcts. Multilevel models were used to assess for associations between arterial characteristics and HIV. Associations between arterial characteristics and brain infarcts were examined in HIV+ individuals only.
resultsAdjusting for vascular risk factors, HIV infection was associated with thicker arterial walls and smaller lumen-to-wall ratios. Cerebral atherosclerosis accounted for one-quarter of the brain infarcts in HIV+ cases, and was more common with aging, diabetes, a lower CD4 nadir, and a higher antemortem CD4 count. In contrast, a higher lumen-to-wall ratio was the only arterial predictor of unexplained infarcts in HIV+ cases. Dolichoectasia was more common in HIV+ cases with smoking and media thinning, and with protracted HIV infection and a detectable antemortem viral load.
conclusionsHIV infection may predispose to inward remodeling compared to uninfected controls. However, among HIV+ cases with protracted immunosuppression, outward remodeling is the defining arterial phenotype. Half of all brain infarcts in this sample were attributed to the extremes of brain arterial remodeling: atherosclerosis and dolichoectasia. Understanding the mechanisms influencing arterial remodeling will be important in controlling cerebrovascular disease in the HIV-infected population.
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