期刊
AIDS
卷 31, 期 6, 页码 847-856出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000001414
关键词
aging; arterial spin labeling; cerebral blood flow; combination antiretroviral therapy; HIV-1-infection; HIV-associated cognitive impairment
资金
- Nuts-OHRA Foundation [1003-026]
- Amsterdam, The Netherlands
- Netherlands Organization for Health Research and Development (ZonMW)
- AIDS Fonds [300020007, 2009063]
- Gilead Sciences
- ViiV Healthcare
- Janssen Pharmaceutica N.V.
- Bristol-Myers Squibb
- Boehringer Ingelheim
- MerckCo.
- National Institute for Health Research [NIHR-RP-011-048] Funding Source: researchfish
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. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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