Prediction of Accelerated Brain Aging in Patients with HIV Infection: The Role of Ventral Diencephalon and Thalamic Volume

Abstract

Introduction: Despite effective viral suppression achieved through combination antiretroviral therapy (cART), HIV (human immunodeficiency virus) infection remains associated with neurological complications and potential accelerated brain aging. The difference between chronological and predicted brain age (Brain Age Gap – BAG) is emerging as an important biomarker of neurodegeneration.

 Aim: The aim of this study was to determine whether a significant difference exists between chronological and estimated brain age in HIV-positive patients compared to healthy controls, using MRI scans and the volBrain software with an integrated brain age estimation module, as well as to develop regression models to assess the contribution of individual brain structures to predicted brain age.  

Materials and Methods: A retrospective study was conducted, including 110 male participants divided into two groups. The first group consisted of HIV-positive patients on therapy (N = 24) and those not receiving treatment (N = 48), while the second group included healthy controls (N = 38). Automated volumetric analysis of MRI scans was performed using the volBrain software. Statistical analysis included t-tests and regression analyses.

 Results: A statistically significant difference between chronological and predicted brain age was observed in HIV-positive patients (p < 0.05), while no significant difference was found in healthy controls. The ventral diencephalon and thalamus volumes were significant negative predictors of predicted brain age (p = 0.00), while the volume of the anterior cingulate gyrus exhibited a trend toward statistical significance.

 Conclusion: Our findings indicate accelerated brain aging in HIV-positive patients, with specific brain structures, such as the thalamus and the ventral diencephalon, contributing significantly to the prediction of biological brain age.