Age-related co-morbidities affect HIV+ adults at younger ages, raising concern for accentuated brain aging. Our lab previously showed that an EEG-based model of brain age reliably predicts chronological age in healthy adults. The differences between EEG-brain age and chronological age, the brain age index (BAI), independently predicts mortality. BAI is also increased by cardiovascular comorbidities. We hypothesized that HIV+ adults have an older brain age and thus higher BAI compared to HIV-negative (HIV-) controls.

To estimate the effect of HIV-1 infection  (HIV+) during antiretroviral therapy (ART) on brain age using a novel sleep-EEG-based biomarker.

Mean chronological age of the HIV+ cohort was 54.9.   In unmatched group comparisons, HIV+ adults had a 5-year elevation in brain age/BAI versus HIV- controls (BAI 5.0 vs. -0.6 years; p-value<0.0001). After matching, the mean HIV+ BAI (+6.5 years) remained higher than HIV- controls (+1.9; mean difference 4.6 years, p-value= 0.001), suggesting that vascular risk factors, common in HIV+ adults, does not fully account for increased brain age in HIV+ adults.  An elevated BAI was seen in 65% of HIV+ cases.

The majority of HIV+ adults on ART had older brain ages than expected for chronological age and predicted to have a 4-year increase in brain age than people without HIV infection. Further work is needed to determine drivers for accentuated brain aging in HIV+ adults on ART.