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Neurometabolite Alterations Associated With Cognitive Performance in Perinatally HIV-Infected Children

Yvonne W Van Dalen1, Charlotte Blokhuis, Sophie Cohen

  • 1From the Department of Pediatric Hematology, Immunology and Infectious Diseases, (YWVD, CB, SC, JATS, HJS, TWK, DP); Psychosocial Department (JATS), Emma Children's Hospital/Academic Medical Center; Neurochemistry Laboratory and Biobank (CET), Department of Clinical Chemistry, VU University Medical Center and Neurocampus Amsterdam, the Netherlands; Neurology (JK), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Experimental Immunology (NAK); Department of Global Health and Amsterdam Institute of Global Health and Development (PR), Academic Medical Center; HIV Monitoring Foundation (PR); Department of Internal Medicine (PR), Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA); and Department of Radiology (CBLMM, MWAC), Academic Medical Center, Amsterdam, the Netherlands.

Medicine
|March 26, 2016
PubMed

Insights

Perinatally HIV-infected children show increased white matter choline levels, indicating glial proliferation, despite combination antiretroviral therapy (cART). Neurometabolite changes correlate with cognitive function, suggesting Magnetic Resonance Spectroscopy (MRS) can assess brain changes in HIV.

Area of Science:

  • Neuroscience
  • Pediatric HIV Research
  • Biochemistry

Background:

  • Cognitive impairment persists in perinatally HIV-infected children despite combination antiretroviral therapy (cART).
  • Cerebral injury may underlie persistent cognitive deficits.
  • Understanding neurometabolite alterations is crucial for assessing brain health in this population.

Purpose of the Study:

  • To compare neurometabolite levels between perinatally HIV-infected children on cART and healthy controls.
  • To evaluate the association between neurometabolites, HIV-related parameters, and cognitive function.
  • To explore the utility of Magnetic Resonance Spectroscopy (MRS) in assessing cerebral changes.

Main Methods:

  • Cross-sectional study involving 26 perinatally HIV-infected children on cART and 36 healthy controls.
  • Magnetic Resonance Spectroscopy (MRS) used to measure N-acetylaspartate (NAA), glutamate (Glu), myo-inositol (mI), and choline (Cho) as ratios over creatine (Cre).
  • Age-adjusted linear regression analyses employed to determine group differences and associations.

Main Results:

  • HIV-infected children exhibited increased white matter choline to creatine ratio (Cho:Cre) (P=0.045), suggesting glial proliferation.
  • Lower nadir CD4+ T-cell counts correlated with reduced neuronal integrity markers (NAA:Cre, Glu:Cre).
  • Centers for Disease Control and Prevention (CDC) stage C diagnosis was linked to higher glial markers (Cho:Cre, mI:Cre); cognitive performance correlated with specific neurometabolite ratios.

Conclusions:

  • Perinatally HIV-infected children on cART show elevated white matter Cho:Cre, indicative of ongoing glial proliferation.
  • Neurometabolite levels, particularly Cho:Cre, NAA:Cre, and Glu:Cre, are associated with cognitive performance.
  • MRS is a potentially valuable tool for assessing cerebral changes and their link to cognitive outcomes in perinatally HIV-infected children.

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