Cerebral blood flow and cognitive function in HIV-infected men with sustained suppressed viremia on combination antiretroviral therapy. (27th March 2017)

• Record Type: Journal Article
• Authors: Su, Tanja; Mutsaerts, Henri J.M.M.; Caan, Matthan W.A.; Wit, Ferdinand W.N.M.; Schouten, Judith; Geurtsen, Gert J.; Sharp, David J.; Prins, Maria; Richard, Edo; Portegies, Peter; Reiss, Peter; Majoie, Charles B.
• Is Part Of: AIDS. Volume 31:Number 6(2017)
• Publication Date: 2017-03-27
• Subjects: aging -- arterial spin labeling -- cerebral blood flow -- combination antiretroviral therapy -- HIV-1-infection -- HIV-associated cognitive impairment; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000001414
• Languages: English
• ISSNs: 0269-9370

Abstract

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.