The regional pattern of abnormal cerebrovascular reactivity in HIV-infected, virally suppressed women.
Andrew L CallenSara M DupontJeffrey PyneJason TalbottPhyllis TienEvan CalabreseDavid SalonerFelicia C ChowJared NarvidPublished in: Journal of neurovirology (2020)
The purpose of this study was to assess whole brain and regional patterns of cerebrovascular reactivity (CVR) abnormalities in HIV-infected women using quantitative whole brain arterial spin labeling (ASL). We hypothesized that HIV-infected women would demonstrate decreased regional brain CVR despite viral suppression. This cross-sectional study recruited subjects from the Bay Area Women's Interagency Health Study (WIHS)-a cohort study designed to investigate the progression of HIV disease in women. In addition to conventional noncontrast cerebral MRI sequences, perfusion imaging was performed before and after the administration of intravenous acetazolamide. CVR was measured by comparing quantitative ASL brain perfusion before and after administration of intravenous acetazolamide. In order to validate and corroborate ASL-based whole brain and regional perfusion, phase-contrast (PC) imaging was also performed through the major neck vessels. FLAIR and susceptibility weighted sequences were performed to assess for white matter injury and microbleeds, respectively. Ten HIV-infected women and seven uninfected, age-matched controls were evaluated. Significant group differences were present in whole brain and regional CVR between HIV-infected and uninfected women. These regional differences were significant in the frontal lobe and basal ganglia. CVR measurements were not significantly impacted by the degree of white matter signal abnormality or presence of microbleeds. Despite complete viral suppression, dysfunction of the neurovascular unit persists in the HIV population. Given the lack of association between CVR and traditional imaging markers of small vessel disease, CVR quantification may provide an early biomarker of pre-morbid vascular disease.
Keyphrases
- hiv infected
- white matter
- antiretroviral therapy
- polycystic ovary syndrome
- human immunodeficiency virus
- high resolution
- hiv positive
- resting state
- pregnancy outcomes
- hiv aids
- contrast enhanced
- cervical cancer screening
- multiple sclerosis
- magnetic resonance
- public health
- cerebral ischemia
- insulin resistance
- bariatric surgery
- breast cancer risk
- sars cov
- low dose
- hepatitis c virus
- metabolic syndrome
- mental health
- oxidative stress
- pregnant women
- subarachnoid hemorrhage
- skeletal muscle
- social media
- health information
- computed tomography
- weight loss
- south africa