Cerebral vasculopathy in HIV infection revealed by transcranial Doppler: A pilot study.
OBJECTIVE
There is growing evidence for affection of cerebral vessels during human immunodeficiency virus (HIV) infection. We prospectively evaluated cerebrovascular reserve capacity (CRC) in HIV-seropositive patients by transcranial Doppler sonography (TCD) after systemic administration of acetazolamide. We hypothesized that a disturbed vasoreactivity would reflect the cerebral arteries' involvement in HIV infection.


METHODS
We assessed the mean blood flow velocity (BFV) of the middle cerebral artery and its increase after intravenous administration of 1 g acetazolamide (CRC) in 31 HIV-infected individuals without symptoms of cerebrovascular disease (mean+/-SD age, 39+/-11 years). Stenotic or occlusive lesions of the large brain-supplying arteries were excluded by color-coded duplex and transcranial imaging. BFV and CRC were also measured in an age-matched group of 10 healthy control subjects. Patients were classified according to clinical, laboratory, and neurophysiological parameters. We also performed cerebral MRI (n=25) and rheumatological blood tests (n=26).


RESULTS
Baseline BFV and CRC both were significantly reduced in HIV-infected patients as compared with control subjects (P<0.05, Student's t test). These findings did not correlate with duration of seropositivity, helper cell count, or other clinical, rheumatological, and neuroradiological findings.


CONCLUSIONS
Our findings support the hypothesis of a cerebral vasculopathy etiologically associated with HIV infection.
Brilla
R
R
Department of Neurology, University of Münster, Münster, Germany.
Nabavi
D G
DG
Schulte-Altedorneburg
G
G
Kemény
V
V
Reichelt
D
D
Evers
S
S
Schiemann
U
U
Husstedt
I W
IW
D015526:AIDS Dementia Complex / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000086:Acetazolamide; D000328:Adult; D017153:Antibodies, Anticardiolipin; D001160:Arterioles / Q000000981:diagnostic imaging / Q000821:virology; D002097:C-Reactive Protein / Q000032:analysis; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000821:virology; D002560:Cerebrovascular Circulation; D004232:Diuretics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017585:Ultrasonography, Doppler, Transcranial
D017153:Antibodies, Anticardiolipin; D004232:Diuretics; D002097:C-Reactive Protein; D000086:Acetazolamide