Serial MRI in HIV Infection With and Without Neurologic Impairment.

G H Dooneief, J A Bello, G G Todak, M X Tang, K S Marder, Y Stern, R P Mayeux
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引用次数: 2

Abstract

To assess the relationship of longitudinal brain magnetic resonance imaging (MRI) and infection with human immunodeficiency virus (HIV), a cohort of HIV+ and HIV− gay men and injection drug users (IDU) were evaluated prospectively. Subjects underwent two evaluations including MRI scans, neurologic examinations, neuropsychological assessments and lymphocyte subset determinations one year apart. MRI changes over a one year period were analyzed with respect to serostatus, risk group, CD4 counts, neurological findings and neuropsychological performance. The frequency of MRI changes was no different in subjects with or without HIV infection and no new opportunistic infections or neoplasms were seen. However, among HIV+ subjects with CD4 count < 200 at the time of the initial scan, an increase in white matter hyperintensities was significantly more common. Also among HIV+ subjects, atrophy increased in association with declining CD4 count. Finally, subjects who developed significant neurologic deterioration in one year were much more likely to have increased atrophy. These results suggest that while there are morphological brain changes associated with HIV infection, they are most often seen in association with immunologic or neurologic deterioration.

伴或不伴神经损伤的HIV感染的序列MRI。
为了评估纵向脑磁共振成像(MRI)与人类免疫缺陷病毒(HIV)感染的关系,一组HIV+和HIV−前瞻性评价男同性恋者和注射吸毒者(IDU)。受试者接受两次评估,包括MRI扫描、神经学检查、神经心理学评估和淋巴细胞亚群测定,间隔一年。分析了一年内的MRI变化,包括血清状态、危险组、CD4计数、神经学结果和神经心理学表现。有无HIV感染的受试者的MRI变化频率无差异,未见新的机会性感染或肿瘤。然而,在初始扫描时CD4计数< 200的HIV阳性受试者中,白质高信号的增加更为常见。同样,在HIV+受试者中,萎缩增加与CD4计数下降有关。最后,在一年内出现明显神经退化的受试者更有可能出现萎缩。这些结果表明,虽然存在与HIV感染相关的脑形态学改变,但它们通常与免疫或神经系统恶化有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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