Published December 2012 | Version v1
Journal article Metadata-only

Two patterns of cerebral metabolite abnormalities are detected on proton magnetic resonance spectroscopy in HIV-infected subjects commencing antiretroviral therapy

Creators

  • 1. Imperial College London, St. Mary's Hospital, London (United Kingdom)
  • 2. HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok (Thailand)
  • 3. Queen Elizabeth Hospital, Hong Kong (China)
  • 4. Calgary Regional Health Authority, Calgary (Canada)
  • 5. University of New South Wales, National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW (Australia)

Description

Cerebral function impairment remains problematic in subjects with chronic human immunodeficiency virus (HIV) infection despite effective combination antiretroviral therapy (cART). Using cerebral proton magnetic resonance spectroscopy (1H MRS), we aimed to determine if abnormalities could be detected in neurologically asymptomatic HIV-infected subjects electively commencing cART. Therapy-naive, HIV-infected individuals and HIV-uninfected controls underwent 1H MRS in several anatomical voxels including the mid-frontal grey matter (FGM) and right basal ganglia (RBG). Differences in cerebral metabolite ratios between groups and correlations between immune and virological status were assessed. Forty-six subjects were recruited (26 HIV-infected and 20 control subjects). In the HIV-infected group, mean CD4+ count (SD, cells per microlitre) and plasma HIV RNA (SD, log10 copies per millilitre) were 192 (86) and 4.71 (0.64), respectively. Choline (Cho)/Creatine (Cr) and myoinositol (MI)/Cr ratios were significantly lower in the FGM in HIV-infected subjects compared to controls (0.67 (0.14) versus 0.88 (0.49), p = 0.036, and 0.94 (0.28) and 1.17 (0.26), p = 0.008, for Cho/Cr and MI/Cr, respectively) and Cho/Cr ratio associated with CD4+ lymphocyte count (p = 0.041). N-Acetyl-aspartate (NAA)/Cho ratio was significantly lower in the RBG in HIV-infected subjects compared to controls (2.27 (0.54) versus 2.63 (0.68), p = 0.002), and this was associated with greater plasma HIV RNA load (p = 0.014). Two patterns of cerebral metabolite abnormalities were observed in HIV-infected subjects electively commencing cART. Greater inflammatory metabolite ratios (Cho/Cr and MI/Cr) associated with lower markers of peripheral immune markers (CD4+ lymphocyte count) in the FGM and lower neuronal metabolite ratios (NAA/Cho) associated with greater HIV viraemia in the RBG were present in HIV-infected subjects. (orig.)

Availability note (English)

Available from: http://dx.doi.org/10.1007/s00234-012-1061-5

Additional details

Identifiers

DOI
10.1007/s00234-012-1061-5;

Publishing Information

Journal Title
Neuroradiology
Journal Volume
54
Journal Issue
12
Journal Page Range
p. 1331-1339
ISSN
0028-3940
CODEN
NRDYAB

INIS

Country of Publication
Germany
Country of Input or Organization
Germany
INIS RN
44035468
Subject category
S62: RADIOLOGY AND NUCLEAR MEDICINE;
Descriptors DEI
AIDS VIRUS; CEREBRUM; CHOLINE; CREATINE; GANGLIONS; HYDROGEN 1; IMAGE PROCESSING; IMMUNITY; IMMUNOLOGY; LYMPHOCYTES; MALFORMATIONS; METABOLITES; NMR IMAGING; NMR SPECTRA; NUCLEAR MAGNETIC RESONANCE; RELAXATION TIME; WEIGHTING FUNCTIONS
Descriptors DEC
ALCOHOLS; AMINO ACIDS; AMMONIUM COMPOUNDS; ANIMAL CELLS; BIOLOGICAL MATERIALS; BLOOD; BLOOD CELLS; BODY; BODY FLUIDS; BRAIN; CARBOXYLIC ACIDS; CENTRAL NERVOUS SYSTEM; CONNECTIVE TISSUE CELLS; DIAGNOSTIC TECHNIQUES; DRUGS; FUNCTIONS; HYDROGEN ISOTOPES; HYDROXY COMPOUNDS; ISOTOPES; LEUKOCYTES; LIGHT NUCLEI; LIPOTROPIC FACTORS; MAGNETIC RESONANCE; MATERIALS; MICROORGANISMS; NERVOUS SYSTEM; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANS; PARASITES; PATHOLOGICAL CHANGES; PROCESSING; QUATERNARY AMMONIUM COMPOUNDS; RESONANCE; SOMATIC CELLS; SPECTRA; STABLE ISOTOPES; VIRUSES

Optional Information

Collaborations
For the Altair Study Group