An individual with human immunodeficiency virus, dementia, and central nervous system amyloid deposition. Issue 1 (14th April 2016)

• Record Type: Journal Article
• Authors: Turner, Raymond Scott; Chadwick, Melanie; Horton, Wesley A.; Simon, Gary L.; Jiang, Xiong; Esposito, Giuseppe
• Is Part Of: Alzheimer's & dementia. Volume 4:Issue 1(2016)
• Page Start: 1
• Page End: 5
• Publication Date: 2016-04-14
• Subjects: Human immunodeficiency virus -- HIV -- HIV‐associated neurocognitive disorder -- HAND -- Dementia -- Alzheimer's disease -- Amyloid PET -- Functional MRI -- Biomarker; Alzheimer's disease -- Periodicals; Alzheimer's disease -- Diagnosis -- Periodicals; Dementia -- Periodicals; Dementia -- Diagnosis -- Periodicals; 616.831
• DOI: 10.1016/j.dadm.2016.03.009
• Languages: English
• ISSNs: 2352-8729

Abstract

Abstract: Human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) is found in 30%–50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71‐year‐old HIV+ individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose–PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Aβ42/tau index but a low phospho‐tau. An amyloid PET/CT with [18F]florbetaben revealed pronounced cortical radiotracer deposition. This case report suggests that progressive dementia in older HIV+ individuals may be due to HAND, AD, or both. HIV infection does not preclude CNS Aβ/amyloid deposition. Amyloid PET imaging may be of value in distinguishing HAND from AD pathologies.