Predictors of CNS injury as measured by proton magnetic resonance spectroscopy in the setting of chronic HIV infection and CART
| Autor: | Jaroslaw Harezlak, Constantin T. Yiannoutsos, Giovanni Schifitto, Deborah McMahon, Jeffery R. Alger, Assawin Gongvatana, Yuen T. So, Elyse J. Singer, Michael J. Taylor, Thomas B. Campbell, Jianhui Zhong, Mark A. Brown, Steven Buchthal, Bradford A. Navia, Ronald A. Cohen, Eric S. Daar |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Cart medicine.medical_specialty Pathology AIDS Dementia Complex Magnetic Resonance Spectroscopy Neurology Metabolite Biology Gastroenterology Basal Ganglia Article Choline White matter Cellular and Molecular Neuroscience chemistry.chemical_compound Neuroimaging Predictive Value of Tests Virology Internal medicine Basal ganglia medicine Humans Longitudinal Studies Gray Matter Aspartic Acid Middle Aged Creatine White Matter Frontal Lobe medicine.anatomical_structure Anti-Retroviral Agents Frontal lobe chemistry Predictive value of tests Chronic Disease Female Neurology (clinical) Protons |
| Zdroj: | Journal of NeuroVirology. 20:294-303 |
| ISSN: | 1538-2443 1355-0284 |
| Popis: | The reasons for persistent brain dysfunction in chronically HIV-infected persons on stable combined antiretroviral therapies (CART) remain unclear. Host and viral factors along with their interactions were examined in 260 HIV-infected subjects who underwent magnetic resonance spectroscopy (MRS). Metabolite concentrations (NAA/Cr, Cho/Cr, MI/Cr, and Glx/Cr) were measured in the basal ganglia, the frontal white matter, and gray matter, and the best predictive models were selected using a bootstrap-enhanced Akaike information criterion (AIC). Depending on the metabolite and brain region, age, race, HIV RNA concentration, ADC stage, duration of HIV infection, nadir CD4, and/or their interactions were predictive of metabolite concentrations, particularly the basal ganglia NAA/Cr and the mid-frontal NAA/Cr and Glx/Cr, whereas current CD4 and the CPE index rarely or did not predict these changes. These results show for the first time that host and viral factors related to both current and past HIV status contribute to persisting cerebral metabolite abnormalities and provide a framework for further understanding neurological injury in the setting of chronic and stable disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink