The following is a summary of “Initiation of combined antiretroviral therapy confers suboptimal beneficial effects on neurovascular function in people with HIV,” published in the August 2023 issue of Neurology by Singh et al.
People living with HIV (PWH) now have an increased risk of age-related cerebrovascular disease (CBVD) due to advances in combined anti-retroviral treatment (cART). Researchers conducted a retrospective study to assess the underlying CNS injury by measuring cerebral blood flow (CBF) and cerebrovascular reactivity (CVR).
They enrolled 35 treatment-naïve PWH and 53 HIV-negative controls (HC). Participants underwent MRI scans to measure CBF and CVR before starting cART treatment and at two time points (12 weeks and 2 years) after cART initiation. Controls were scanned at baseline and the 2-year visit. They assessed plasma levels of microparticles from endothelial and glial sources and inflammatory markers ICAM-1 and VCAM-1 to evaluate HIV-associated endothelial inflammation and its interaction with brain neurovascular function.
The results revealed that HIV infection was linked to decreased CVR and elevated endothelial and glial microparticles (MPs) levels before starting cART. There was a negative correlation between CVR and peripheral MP levels in PWH.
Investigators concluded cART treatment benefits neurovascular function, but the benefits are suboptimal over time.