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

Tanja Su1, Henri J M M Mutsaerts, Matthan W A Caan

  • 1aDepartment 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.

AIDS (London, England)
|January 26, 2017
PubMed

Insights

Cerebral blood flow (CBF) is reduced in HIV-infected patients on long-term antiretroviral therapy compared to controls. This hemodynamic alteration is linked to vascular risk factors and past immune deficiency, but not cognitive impairment in this cohort.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Radiology

Background:

  • HIV infection can affect the brain, even with effective treatment.
  • Cerebral blood flow (CBF) alterations may indicate underlying vascular issues.
  • Understanding these changes is crucial for managing long-term HIV health.

Purpose of the Study:

  • To compare CBF in HIV-infected patients on successful combination antiretroviral therapy (cART) with HIV-uninfected controls.
  • To investigate if CBF alterations correlate with HIV-associated cognitive impairment.
  • To identify potential determinants of CBF changes in HIV-infected individuals.

Main Methods:

  • A cross-sectional observational study compared 100 HIV-infected men on cART with 69 HIV-uninfected controls.
  • Cerebral blood flow (CBF) maps were generated using pseudocontinuous arterial spin labeling MRI.
  • Regression analyses explored associations between gray matter CBF and clinical/cognitive parameters.

Main Results:

  • HIV-infected patients exhibited decreased gray matter CBF compared to controls (P=0.02).
  • Reduced CBF in HIV-infected individuals was associated with higher triglyceride levels and prior AIDS diagnosis.
  • No significant association was found between CBF and cognitive impairment in this cohort.

Conclusions:

  • Long-term successful cART in HIV patients is associated with decreased CBF, suggesting increased cerebrovascular disease.
  • These hemodynamic alterations correlate with vascular risk factors and past immune deficiency.
  • Despite CBF changes, overt cognitive impairment was not evident in this treated HIV cohort.
Abstract