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. 2016 Jan 1;71(1):24-30.
doi: 10.1097/QAI.0000000000000779.

Neuronal-Glia Markers by Magnetic Resonance Spectroscopy in HIV Before and After Combination Antiretroviral Therapy

Napapon Sailasuta  1 , Jintanat Ananworanich, Sukalaya Lerdlum, Pasiri Sithinamsuwan, James L K Fletcher, Somporn Tipsuk, Mantana Pothisri, Tanate Jadwattanakul, Supunnee Jirajariyavej, Thep Chalermchai, Stephanie Catella, Edgar Busovaca, Akash Desai, Robert Paul, Victor Valcour; SEARCH 011 Study Group
Affiliations

Neuronal-Glia Markers by Magnetic Resonance Spectroscopy in HIV Before and After Combination Antiretroviral Therapy

Napapon Sailasuta et al. J Acquir Immune Defic Syndr. .

Abstract

Objective: Combination antiretroviral therapy (cART) can suppress plasma HIV RNA to undetectable levels; yet reports indicate persistent HIV-associated neurocognitive disorders (HAND) among treated individuals. We sought to investigate imaging correlates of incomplete cognitive recovery among individuals with chronic HIV.

Methods: We used single voxel proton magnetic resonance spectroscopy in 4 regions of the brain to measure changes in neuronal and glia biomarkers in cART-naive subjects before (n = 59, 27 with HAND) and after 12 months of cART.

Results: At baseline, we observed elevated total choline (CHO) in the basal ganglia (BG, P = 0.002) and in the posterior cingulate gyrus (PCG, P = 0.022) associated with HIV infection. Myo-inositol (MI) was elevated in the frontal white matter (FWM, P = 0.040). N-acetylaspartate was elevated in the BG (P = 0.047). Using a mixed model approach among all HIV-infected individuals, at 6 months, we observed decreased n- acetylaspartate in FWM (P = 0.031), decreased creatine in PCG (P = 0.026) and increased MI in frontal gray matter (FGM, P = 0.023). At 12 months, we observed an increase in BG MI (P = 0.038) and in FGM (P = 0.021). Compared to those with normal cognition, HAND cases had higher FGM MI (P = 0.014) at baseline. At 12 months, individuals that remained cognitively impaired compared with those without HAND exhibited elevated CHO in the PCG (P = 0.018) and decreased glutamate in both FWM (P = 0.027) and BG (P = 0.013).

Conclusions: cART started during chronic HIV is associated with reduced neuronal-glia and inflammatory markers. Alterations in CHO are noted among individuals who remain impaired after 12 months of cART.

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Figures

Figure 1
Figure 1
Longitudinal changes in MRS measures across the three time points (pre-cART, 6 months, and 12 months post cART) in HIV-infected subjects. A paired t-test is used with box plot with whiskers at 10th and 90th percentile.
See this image and copyright information in PMC

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