TY - JOUR
T1 - Cerebral blood flow and cognitive function in HIV-infected men with sustained suppressed viremia on combination antiretroviral therapy
AU - Su, Tanja
AU - Mutsaerts, Henri J.M.M.
AU - Caan, Matthan W.A.
AU - Wit, Ferdinand W.N.M.
AU - Schouten, Judith
AU - Geurtsen, Gert J.
AU - Sharp, David J.
AU - Prins, Maria
AU - Richard, Edo
AU - Portegies, Peter
AU - Reiss, Peter
AU - Majoie, Charles B.
PY - 2017/3/27
Y1 - 2017/3/27
N2 - Objective: To assess if HIV-infected patients on long-term successful combination antiretroviral therapy show cerebral blood flow (CBF) alterations in comparison with 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. Design: Cross-sectional comparison of CBF in an observational cohort study. Methods: Clinical, cognitive and MRI data of 100 middle-aged aviremic HIV-infected men on combination antiretroviral therapy and 69 HIV-uninfected controls were collected and compared. From pseudocontinuous arterial spin labeling MRI data, CBF-maps were calculated. The associations of mean gray matter CBF with clinical and cognitive parameters were explored in regression models, followed by a spatial delineation in a voxel-based analysis. Results: CBF was decreased in HIV-infected patients compared with HIV-uninfected controls (P=0.02), adjusted for age, ecstasy use and waist circumference. Spatially distinct and independent effects of total gray matter 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. Conclusion: 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.
AB - Objective: To assess if HIV-infected patients on long-term successful combination antiretroviral therapy show cerebral blood flow (CBF) alterations in comparison with 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. Design: Cross-sectional comparison of CBF in an observational cohort study. Methods: Clinical, cognitive and MRI data of 100 middle-aged aviremic HIV-infected men on combination antiretroviral therapy and 69 HIV-uninfected controls were collected and compared. From pseudocontinuous arterial spin labeling MRI data, CBF-maps were calculated. The associations of mean gray matter CBF with clinical and cognitive parameters were explored in regression models, followed by a spatial delineation in a voxel-based analysis. Results: CBF was decreased in HIV-infected patients compared with HIV-uninfected controls (P=0.02), adjusted for age, ecstasy use and waist circumference. Spatially distinct and independent effects of total gray matter 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. Conclusion: 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.
KW - HIV-1-infection
KW - HIV-associated cognitive impairment
KW - aging
KW - arterial spin labeling
KW - cerebral blood flow
KW - combination antiretroviral therapy
UR - http://www.scopus.com/inward/record.url?scp=85010869430&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/QAD.0000000000001414
DO - https://doi.org/10.1097/QAD.0000000000001414
M3 - Article
C2 - 28121708
SN - 0269-9370
VL - 31
SP - 847
EP - 856
JO - AIDS
JF - AIDS
IS - 6
ER -