Neuronal-Glia Markers by Magnetic Resonance Spectroscopy in HIV Before and After Combination Antiretroviral Therapy. (1st January 2016)

• Record Type: Journal Article
• Authors: Sailasuta, Napapon; Ananworanich, Jintanat; Lerdlum, Sukalaya; Sithinamsuwan, Pasiri; Fletcher, James L. K.; Tipsuk, Somporn; Pothisri, Mantana; Jadwattanakul, Tanate; Jirajariyavej, Supunnee; Chalermchai, Thep; Catella, Stephanie; Busovaca, Edgar; Desai, Akash; Paul, Robert; Valcour, Victor
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 71:Number 1(2016)
• Publication Date: 2016-01-01
• Subjects: HIV -- magnetic resonance spectroscopy -- cognitive disorders; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000000779
• Languages: English
• ISSNs: 1525-4135

Abstract

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. Abstract : Supplemental Digital Content is Available in the Text.