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J Acquir Immune Defic Syndr. 2016 Jan 1;71(1):24-30. doi: 10.1097/QAI.0000000000000779.

Neuronal-Glia Markers by Magnetic Resonance Spectroscopy in HIV Before and After Combination Antiretroviral Therapy.

Author information

1
*Department of Tropical Medicine, University of Hawaii, Honolulu, HI;†U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD;‡Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD;§SEARCH, Thai Red Cross AIDS Research Center, Bangkok, Thailand;‖Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;¶Division of Neurology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand;#Queen Savang Vadhana Memorial Hospital, Chomburi, Thailand;**Taksin Hospital, Bangkok, Thailand;††Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA; and‡‡Department of Psychology, Missouri Institute of Mental Health, University of Missouri, St. Louis, MO.

Abstract

OBJECTIVE:

Combination antiretroviral therapy (cART) can suppress plasma HIV RNA to undetectable levels; yet reports indicate persistent HIV-associated neurocognitive disorders (HAND) among treated individuals. We sought to investigate imaging correlates of incomplete cognitive recovery among individuals with chronic HIV.

METHODS:

We used single voxel proton magnetic resonance spectroscopy in 4 regions of the brain to measure changes in neuronal and glia biomarkers in cART-naive subjects before (n = 59, 27 with HAND) and after 12 months of cART.

RESULTS:

At baseline, we observed elevated total choline (CHO) in the basal ganglia (BG, P = 0.002) and in the posterior cingulate gyrus (PCG, P = 0.022) associated with HIV infection. Myo-inositol (MI) was elevated in the frontal white matter (FWM, P = 0.040). N-acetylaspartate was elevated in the BG (P = 0.047). Using a mixed model approach among all HIV-infected individuals, at 6 months, we observed decreased n- acetylaspartate in FWM (P = 0.031), decreased creatine in PCG (P = 0.026) and increased MI in frontal gray matter (FGM, P = 0.023). At 12 months, we observed an increase in BG MI (P = 0.038) and in FGM (P = 0.021). Compared to those with normal cognition, HAND cases had higher FGM MI (P = 0.014) at baseline. At 12 months, individuals that remained cognitively impaired compared with those without HAND exhibited elevated CHO in the PCG (P = 0.018) and decreased glutamate in both FWM (P = 0.027) and BG (P = 0.013).

CONCLUSIONS:

cART started during chronic HIV is associated with reduced neuronal-glia and inflammatory markers. Alterations in CHO are noted among individuals who remain impaired after 12 months of cART.

PMID:
26258565
PMCID:
PMC4713260
DOI:
10.1097/QAI.0000000000000779
[Indexed for MEDLINE]
Free PMC Article

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