Gutierrez J, Porras TN, Yoo-Jeong M, et al. - This cross-sectional, community-based study of people living with HIV (PLWH) in New York City (aged 50 years or older) revealed silent brain infarcts, intracranial large artery stenosis, and poor white matter integrity as exposures that may influence cognitive decline in these individuals.

• Most of the participants had well-controlled HIV (75% with CD4 cell count > 200 cells/mm³ and viral load < 400 copies/mL at or near the time of the MRI scan).

• Poorer performance in at least one cognitive domain was recorded in correlation with presence of silent brain infarcts, intracranial large artery stenosis, and poor white matter integrity.

• The sum of these 3 MRI markers of cerebrovascular disease was linked with lower working memory, list learning, and global cognition.

• These MRI markers of CVD may aid in recognizing PLWH at greater risk of cognitive decline.