2011
DOI: 10.1097/qad.0b013e3283427da7
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Abstract: Objective To determine whether cognitive impairment and brain injury as measured by proton magnetic resonance spectroscopy (MRS) persist in the setting of highly active antiretroviral therapy (HAART). Design This study is an observational cohort study. Methods MRS was performed in 268 patients: HIV-negative controls (N=28), HIV-positive neuroasymptomatic (NA) subjects (N=124), and subjects with AIDS Dementia Complex (ADC; N=50) on stable ART with a mean duration of infection of 12 years and CD4 of 309 cell… Show more

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Cited by 300 publications
(284 citation statements)
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“…Reversibility of Cho/Cr and MI/Cr may occur beyond follow-up, but this is unlikely as persistent neuroinflammation has been reported in chronic infection on stable ART. 9 An early infection study with 8 individuals scanned within months of initial HIV exposure reported low NAA in the frontal cortical gray matter as compared to seronegative controls. All individuals reported symptoms of acute HIV syndrome and 5 additionally reported severe headaches, numbness in extremities, and difficulty thinking clearly.…”
Section: Magnetic Resonance Spectroscopymentioning
confidence: 99%
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“…Reversibility of Cho/Cr and MI/Cr may occur beyond follow-up, but this is unlikely as persistent neuroinflammation has been reported in chronic infection on stable ART. 9 An early infection study with 8 individuals scanned within months of initial HIV exposure reported low NAA in the frontal cortical gray matter as compared to seronegative controls. All individuals reported symptoms of acute HIV syndrome and 5 additionally reported severe headaches, numbness in extremities, and difficulty thinking clearly.…”
Section: Magnetic Resonance Spectroscopymentioning
confidence: 99%
“…1,4,5 Low glutamate (Glu) is also reported in CHI with cognitive impairment and is thought to reflect neuronal and glial cell dysfunction. 6 Antiretroviral therapy (ART) offers limited reversibility 7,8 even for CHI on stable long-term therapy, 9 suggesting that early HIV invasion of the CNS 10,11 and accrued neuronal damage 12 may contribute to the substantial prevalence of HIV-associated neurocognitive disorders in the era of ART. 13,14 1 H-MRS studies during primary HIV infection (PHI, the first year after HIV transmission) describes inflammation with trends of elevated Cho/creatine-containing metabolites (Cr) and MI/Cr with potentially neurotoxic levels of Glx (combined glutamate and glutamine peak) 10,15 ; this corresponds with neuropathologic immune activation previously reported in PHI.…”
mentioning
confidence: 99%
“…Both neuroasymptomatic HIV1 individuals and patients with HAND exhibit elevated NAA/ Cr and Cho/Cr, signifying inflammatory responses. 3 In contrast, decreases in NAA, a neuronal marker, are typically associated with HIV-related cognitive impairment 3 and dementia, 26 although reduced NAA has been detected in early HIV infection. 27 MRS may be more sensitive than structural MRI to basal ganglia alterations in the initial stages of HAND.…”
mentioning
confidence: 99%
“…2 The mechanism whereby suppressed HIV viremia can induce neuronal injury and neuropsychological deficits 3 remains unclear. HIV DNA in peripheral blood mononuclear cells (PBMCs) constitutes a viral reservoir that may contribute to ongoing neurologic impairment.…”
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confidence: 99%
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