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AIDS. 2017 Mar 27;31(6):847-856. doi: 10.1097/QAD.0000000000001414.

Cerebral blood flow and cognitive function in HIV-infected men with sustained suppressed viremia on combination antiretroviral therapy.

Author information

1
aDepartment of Radiology bDepartment of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development (AIGHD) cCenter for Infection and Immunity Amsterdam (CINIMA), Division of Infectious Diseases, Department of Internal Medicine dDepartment of Neurology eDepartment of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands fThe Computational, Cognitive, and Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, UK gPublic Health Service Amsterdam, Infectious Diseases Research, Amsterdam hDepartment of Neurology, Radboud University Medical Centre, Nijmegen iDepartment of Neurology, Onze Lieve Vrouwe Gasthuis (OLVG Hospital) jHIV Monitoring Foundation, Amsterdam, The Netherlands.

Abstract

OBJECTIVE:

To assess if HIV-infected patients on long-term successful combination antiretroviral therapy show cerebral blood flow (CBF) alterations in comparison with HIV-uninfected, otherwise similar controls. To explore whether such alterations are associated with HIV-associated cognitive impairment and to explore potential determinants of CBF alterations in HIV.

DESIGN:

Cross-sectional comparison of CBF in an observational cohort study.

METHODS:

Clinical, cognitive and MRI data of 100 middle-aged aviremic HIV-infected men on combination antiretroviral therapy and 69 HIV-uninfected controls were collected and compared. From pseudocontinuous arterial spin labeling MRI data, CBF-maps were calculated. The associations of mean gray matter CBF with clinical and cognitive parameters were explored in regression models, followed by a spatial delineation in a voxel-based analysis.

RESULTS:

CBF was decreased in HIV-infected patients compared with HIV-uninfected controls (P = 0.02), adjusted for age, ecstasy use and waist circumference. Spatially distinct and independent effects of total gray matter volume and HIV-serostatus on CBF were found. Within the HIV-infected group, decreased CBF was associated with increased triglyceride levels (P = 0.005) and prior clinical AIDS (P = 0.03). No association between CBF and cognitive impairment was found.

CONCLUSION:

Decreased CBF was observed among HIV-infected patients, which was associated with both vascular risk factors as well as with measures of past immune deficiency. These results provide support for increased vascular disease in HIV-infected patients as represented by hemodynamic alteration, but without overt cognitive consequences within the current cohort of patients on long-term successful treatment.

PMID:
28121708
DOI:
10.1097/QAD.0000000000001414
[Indexed for MEDLINE]

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