AIDS (London, England) 2017 01 24() doi 10.1097/QAD.0000000000001414
To assess if HIV-infected patients on long-term successful combination antiretroviral therapy (cART) show cerebral blood flow (CBF) alterations in comparison to HIV-uninfected, otherwise similar controls. To explore whether such alterations are associated with HIV-associated cognitive impairment and to explore potential determinants of CBF alterations in HIV.
Cross-sectional comparison of CBF in an observational cohort study.
Clinical, cognitive and magnetic resonance imaging (MRI) data of 100 middle-aged aviremic HIV-infected men on cART and 69 HIV-uninfected controls were collected and compared. From pseudo-continuous arterial spin labeling (ASL) MRI data, CBF-maps were calculated. The associations of mean grey matter (GM) CBF with clinical and cognitive parameters were explored in regression models, followed by a spatial delineation in a voxel-based analysis.
CBF was decreased in HIV-infected patients compared to HIV-uninfected controls (p = 0.02), adjusted for age, ecstasy use, and waist circumference. Spatially distinct and independent effects of total GM volume and HIV-serostatus on CBF were found. Within the HIV-infected group, decreased CBF was associated with increased triglyceride levels (p = 0.005) and prior clinical AIDS (p = 0.03). No association between CBF and cognitive impairment was found.
Decreased CBF was observed among HIV-infected patients, which was associated with both vascular risk factors as well as with measures of past immune deficiency. These results provide support for increased vascular disease in HIV-infected patients as represented by hemodynamic alteration, but without overt cognitive consequences within the current cohort of patients on long-term successful treatment.