Predictors of CNS injury as measured by proton magnetic resonance spectroscopy in the setting of chronic HIV infection and CART.
Title | Predictors of CNS injury as measured by proton magnetic resonance spectroscopy in the setting of chronic HIV infection and CART. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Harezlak, J, Cohen, R, Gongvatana, A, Taylor, M, Buchthal, S, Schifitto, G, Zhong, J, Daar, ES, Alger, JR, Brown, M, Singer, EJ, Campbell, TB, McMahon, D, So, YT, Yiannoutsos, CT, Navia, BA |
Corporate Authors | HIV Neuroimaging Consortium, |
Journal | J Neurovirol |
Volume | 20 |
Issue | 3 |
Pagination | 294-303 |
Date Published | 2014 Jun |
ISSN | 1538-2443 |
Keywords | Adult, AIDS Dementia Complex, Anti-Retroviral Agents, Aspartic Acid, Basal Ganglia, Choline, Chronic Disease, Creatine, External, Female, Frontal Lobe, Gray Matter, Humans, Longitudinal Studies, Magnetic Resonance Spectroscopy, Male, Middle Aged, Predictive Value of Tests, Protons, White Matter |
Abstract | The reasons for persistent brain dysfunction in chronically HIV-infected persons on stable combined antiretroviral therapies (CART) remain unclear. Host and viral factors along with their interactions were examined in 260 HIV-infected subjects who underwent magnetic resonance spectroscopy (MRS). Metabolite concentrations (NAA/Cr, Cho/Cr, MI/Cr, and Glx/Cr) were measured in the basal ganglia, the frontal white matter, and gray matter, and the best predictive models were selected using a bootstrap-enhanced Akaike information criterion (AIC). Depending on the metabolite and brain region, age, race, HIV RNA concentration, ADC stage, duration of HIV infection, nadir CD4, and/or their interactions were predictive of metabolite concentrations, particularly the basal ganglia NAA/Cr and the mid-frontal NAA/Cr and Glx/Cr, whereas current CD4 and the CPE index rarely or did not predict these changes. These results show for the first time that host and viral factors related to both current and past HIV status contribute to persisting cerebral metabolite abnormalities and provide a framework for further understanding neurological injury in the setting of chronic and stable disease. |
DOI | 10.1007/s13365-014-0246-6 |
Alternate Journal | J Neurovirol |
PubMed ID | 24696364 |
PubMed Central ID | PMC4041596 |
Grant List | U01MH083500 / MH / NIMH NIH HHS / United States U24 MH100929 / MH / NIMH NIH HHS / United States R01 NS036524 / NS / NINDS NIH HHS / United States U01 MH083500 / MH / NIMH NIH HHS / United States UM1 AI069424 / AI / NIAID NIH HHS / United States UL1 RR025780 / RR / NCRR NIH HHS / United States U24 MH100928 / MH / NIMH NIH HHS / United States NS038841 / NS / NINDS NIH HHS / United States R24 NS038841 / NS / NINDS NIH HHS / United States UL1 TR001108 / TR / NCATS NIH HHS / United States P30 AG028740 / AG / NIA NIH HHS / United States U54 EB020403 / EB / NIBIB NIH HHS / United States R01 MH099921 / MH / NIMH NIH HHS / United States AI069424 / AI / NIAID NIH HHS / United States R00 AA020235 / AA / NIAAA NIH HHS / United States U01MH083506 / MH / NIMH NIH HHS / United States NS36524 / NS / NINDS NIH HHS / United States U01 MH083506 / MH / NIMH NIH HHS / United States UL1 TR001082 / TR / NCATS NIH HHS / United States U01 AI069424 / AI / NIAID NIH HHS / United States RR025780 / RR / NCRR NIH HHS / United States MH083506 / MH / NIMH NIH HHS / United States |