ERP evidence of impaired central nervous system function in virally suppressed HIV patients on antiretroviral therapy

Abstract

Objective: To examine the effects of human immunodeficiency virus (HIV) on central nervous system (CNS) function in patients receiving antiretroviral therapy (ART) who have suppressed viral loads.

Methods: Event-related brain potentials (ERPs) were recorded from 15 virally suppressed HIV patients and 15 age-, sex-, and education-matched controls while they performed a 3-stimulus auditory oddball task. The amplitude and latency of the P3a, P3b, and early auditory components were examined in HIV patients and controls.

Results: Virally suppressed HIV patients on ART were more depressed than controls, as determined by the Beck Depression Inventory (BDI). After controlling for the effects of depression, HIV patients had smaller P2, P3a, and P3b amplitudes and longer P3a and P3b latency than control subjects. BDI scores correlated positively with N1 latency in HIV patients and negatively with P3b amplitude in all subjects.

Conclusions: These electrophysiological results suggest that, even in the absence of detectable levels of HIV in the peripheral blood, viral replication persists in the CNS and continues to cause disease in HIV patients on ART.

Fig. 1

Grand averaged ERPs to the standard stimuli for controls (thick solid line) and HIV + patients (thin dashed line) at 6 midline electrodes.

Fig. 2

Grand averaged ERPs to the infrequent, non-target stimuli for controls (thick solid line) and HIV + patients (thin dashed line) at 28 electrodes.

Fig. 3

Grand averaged ERPs to correctly detected frequent, target stimuli for controls (thick solid line) and HIV + patients (thin dashed line) at 28 electrodes.