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Cerebral single-photon emission computed tomography abnormalities in human immunodeficiency virus type 1-infected gay
N Sacktor1, I Prohovnik, R L Van Heertum
1Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA.
Objective:
To determine whether technetium Tc99m exametazime single-photon computed emission tomography (SPECT) can distinguish gay human immunodeficiency virus (HIV)-positive subjects, both with and without mild cognitive impairment, from gay HIV-negative control subjects.
Design:
Twenty HIV-positive subjects (12 without cognitive impairment and eight with mild cognitive impairment) and 10 HIV-negative subjects underwent neurological, neuropsychological, magnetic resonance imaging, and technetium Tc 99m exametazime SPECT examinations.
Setting:
Subjects were recruited from a natural history study of gay men with HIV infection.
Patients:
Subjects from the cohort who had previously participated in a magnetic resonance imaging study were selected for the SPECT study.
Main Outcome Measures:
The SPECT scans were rated as abnormal if focal defects, confirmed by a horizontal profile analysis, were seen.
Results:
Sixty-seven percent of HIV-positive subjects without cognitive impairment, 88% of HIV-positive subjects with mild cognitive impairment, and 20% of HIV-negative subjects had abnormal SPECT scans (P < .05 for both HIV-positive groups when each group was compared with HIV-negative subjects).
Conclusion:
Compared with gay HIV-negative control subjects, focal SPECT defects are seen with an increased frequency in HIV-positive gay men without cognitive impairment and in HIV-positive gay men with mild cognitive impairment.