Cerebral blood flow and cognitive function in HIV-infected men with sustained suppressed viremia on combination antiretroviral therapy

Tanja Su, Henri J.M.M. Mutsaerts, Matthan W.A. Caan, Ferdinand W.N.M. Wit, Judith Schouten, Gert J. Geurtsen, David J. Sharp, Maria Prins, Edo Richard, Peter Portegies, Peter Reiss, Charles B. Majoie*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)847-856
Number of pages10
JournalAIDS
Volume31
Issue number6
DOIs
Publication statusPublished - 27 Mar 2017

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