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Cerebral proton magnetic resonance spectroscopy in asymptomatic HIV infection
I D Wilkinson1, R F Miller, K A Miszkiel
1Department of Medical Physics and Bioengineering, Middlesex Hospital, University College London Hospitals, NHS Trust, UK.
Objective:
To determine whether proton magnetic resonance spectroscopy (MRS) demonstrates central nervous system abnormalities in asymptomatic HIV-1-infected individuals.
Design:
Both prospective and retrospective cross-sectional analyses of MRS in asymptomatic HIV-infected individuals.
Setting:
Two specialists HIV/AIDS outpatient facilities in London.
Participants:
Eighty-four HIV-1 seropositive asymptomatic men; 29 HIV-1 antibody-negative homosexual men at high-risk for HIV infection and 48 HIV-1 antibody-negative men at low-risk for HIV infection as controls.
Main Outcome Measures:
Single voxel, gradient-localized proton MRS performed at 1.5 T with 135 msec echo-time and 1,600 msec repeat-time in an 8 ml volume of interest positioned in the parieto-occipital white matter. Spectroscopic results were expressed as ratios between the areas under the N-acetyl (NA), creatine (Cr) and choline (Cho) resonance peaks.
Results:
There were no differences between those controls at high and those at low-risk for HIV infection. Comparing the combined control groups with the asymptomatic seropositive patients there were statistically significant differences in NA/Cho, NA/Cr (both P < 0.05) and NA/(NA + Cho + Cr) (P < 0.01).
Conclusion:
Abnormalities in cerebral biochemistry may be demonstrated by proton MRS during asymptomatic HIV-1 infection.