Differences in the direction of change of cerebral function parameters are evident over three years in HIV-infected individuals electively commencing initial cART

Winston, Alan, Puls, Rebekah, Kerr, Stephen J., Duncombe, Chris, Li, Patrick, Gill, John M., Ramautarsing, Reshmie, Taylor-Robinson, Simon D., Emery, Sean and Cooper, David A. (2015) Differences in the direction of change of cerebral function parameters are evident over three years in HIV-infected individuals electively commencing initial cART. Plos One, 10 2: . doi:10.1371/journal.pone.0118608

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Author Winston, Alan
Puls, Rebekah
Kerr, Stephen J.
Duncombe, Chris
Li, Patrick
Gill, John M.
Ramautarsing, Reshmie
Taylor-Robinson, Simon D.
Emery, Sean
Cooper, David A.
Title Differences in the direction of change of cerebral function parameters are evident over three years in HIV-infected individuals electively commencing initial cART
Journal name Plos One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2015-02-01
Year available 2015
Sub-type Article (original research)
DOI 10.1371/journal.pone.0118608
Open Access Status DOI
Volume 10
Issue 2
Total pages 10
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Language eng
Formatted abstract
Background
Changes in cerebral metabolite ratios (CMR) measured on 1H-MRS and changes in cognitive function (CF) are described in subjects commencing combination antiretroviral therapy (cART), although the dynamics of such changes are poorly understood.

Methods
Neuroasymptomatic, HIV-infected subjects electively commencing cART were eligible. CMR were assessed in three anatomical voxels and CF assessed at baseline, week 48 and week 144. Overall differences in absolute change in CMRs and CF parameters between 0–48 and 48–144 weeks were assessed.

Results
Twenty-two subjects completed study procedures. Plasma HIV-RNA was <50 copies/mL in all at week 48 and in all, but two subjects at week 144. In general, between weeks 0–48 a rise in N-acetyl-aspartate(NAA)/Creatine(Cr) ratio and a decline in myo-Inositol(mI)/Cr ratio were observed. Between weeks 48–144, small rises in NAA/Cr ratio were observed in two anatomical voxels, whereas a rise in mI/Cr ratio was observed in all anatomical locations (0.31 (0.66) and -0.27 (1.35) between weeks 0–48 and 0.13 (0.91) and 1.13 (1.71) between weeks 48–144 for absolute changes in NAA/Cr and mI/Cr (SD) in frontal-grey voxel, respectively). Global CF score improved between weeks 0–48 and then declined between weeks 48–144 (0.63 (1.16) and -0.63 (0.1.41) for mean absolute change (SD) between weeks 0–48 and weeks 48–144, respectively).

Conclusions
The direction of change of cerebral function parameters differs over time in HIV-infected subjects commencing cART, highlighting the need for long-term follow-up in such studies. The changes we have observed between weeks 48–144 may represent the initial development of cerebral toxicities from cART.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Medicine
 
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