HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.

<h4>Background</h4>Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers r...

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Autores principales:	Lucette A Cysique, Kirsten Moffat, Danielle M Moore, Tammy A Lane, Nicholas W S Davies, Andrew Carr, Bruce J Brew, Caroline Rae
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d8c71e65fc344b9fa17ea9c6d2eebbd5
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spelling	oai:doaj.org-article:d8c71e65fc344b9fa17ea9c6d2eebbd52021-11-18T07:48:43ZHIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.1932-620310.1371/journal.pone.0061738https://doaj.org/article/d8c71e65fc344b9fa17ea9c6d2eebbd52013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23620788/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear.<h4>Methods</h4>92 HIV- infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV-) subjects underwent (1)H Magnetic Resonance Spectroscopy (MRS) of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury), caudate nucleus (targeting HIV neurochemical injury), and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes). All also underwent standard neuropsychological (NP) testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF) neuroinflammation biomarkers were obtained in 38 HIV+ individuals.<h4>Results</h4>Relative to HIV- individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA) (p<.04) and higher myo-inositol (mIo) (p<.04); in the caudate: lower NAA (p = .01); and in the posterior cingulate cortex: higher mIo (p<.008- also significant when Holm-Sidak corrected) and higher Choline/NAA (p<.04). Regression models showed that an HIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal white matter.<h4>Conclusions</h4>In chronically HIV+ adults with long-term viral suppression, current CVD risk, past CVD and age are independent factors for neuronal injury and inflammation. This suggests a tripartite model of HIV, CVD and age likely driven by chronic inflammation.Lucette A CysiqueKirsten MoffatDanielle M MooreTammy A LaneNicholas W S DaviesAndrew CarrBruce J BrewCaroline RaePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 4, p e61738 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lucette A Cysique Kirsten Moffat Danielle M Moore Tammy A Lane Nicholas W S Davies Andrew Carr Bruce J Brew Caroline Rae HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
description	<h4>Background</h4>Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear.<h4>Methods</h4>92 HIV- infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV-) subjects underwent (1)H Magnetic Resonance Spectroscopy (MRS) of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury), caudate nucleus (targeting HIV neurochemical injury), and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes). All also underwent standard neuropsychological (NP) testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF) neuroinflammation biomarkers were obtained in 38 HIV+ individuals.<h4>Results</h4>Relative to HIV- individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA) (p<.04) and higher myo-inositol (mIo) (p<.04); in the caudate: lower NAA (p = .01); and in the posterior cingulate cortex: higher mIo (p<.008- also significant when Holm-Sidak corrected) and higher Choline/NAA (p<.04). Regression models showed that an HIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal white matter.<h4>Conclusions</h4>In chronically HIV+ adults with long-term viral suppression, current CVD risk, past CVD and age are independent factors for neuronal injury and inflammation. This suggests a tripartite model of HIV, CVD and age likely driven by chronic inflammation.
format	article
author	Lucette A Cysique Kirsten Moffat Danielle M Moore Tammy A Lane Nicholas W S Davies Andrew Carr Bruce J Brew Caroline Rae
author_facet	Lucette A Cysique Kirsten Moffat Danielle M Moore Tammy A Lane Nicholas W S Davies Andrew Carr Bruce J Brew Caroline Rae
author_sort	Lucette A Cysique
title	HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
title_short	HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
title_full	HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
title_fullStr	HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
title_full_unstemmed	HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.
title_sort	hiv, vascular and aging injuries in the brain of clinically stable hiv-infected adults: a (1)h mrs study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/d8c71e65fc344b9fa17ea9c6d2eebbd5
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HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study.

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