Antiretroviral therapy and its influence on the stage of brain damage in patients with HIV - 1H MRS evaluation.
BACKGROUND
MR proton spectroscopy (1H MRS) enables early detection of metabolic changes, which occur in the course of AIDS Dementia Complex Syndrome (ADC). The goal of the study was the evaluation of highly active antiretroviral therapy (HAART) and its influence on the character and intensity of metabolic changes in brain 1H MRS spectra in clinically asymptomatic HIV-infected patients as well as search for correlation between the treatment and 1H MR spectroscopy results and immune deficit degree.


METHODS
In the group of 20 HIV+ patients, the examination of the central nervous system (CNS), MR and 1H MRS were conducted twice:before HAART treatment and during the therapy; on average after 6 months (4 -9 months of treatment).


RESULTS
The levels of NAA/Cr in the control MRS examination were close to the values observed before treatment. However, statistically significant increase in NAA/Cho ratio (p<0.05) was noticed. The control examination showed statistically decrease of Cho/Cr and mI/Cr ratios, though statistically insignificant (p>0.05). NAA and Cr contents in reference to the signal of non-suppressed water increased insignificantly in the follow-up examination. However, statistically significant decrease in Cho/H(2)O and mI/H(2)O levels (p<0.05) was observed.


CONCLUSIONS
The therapy with HAART affects normalization of metabolite levels in the central nervous system in clinically asymptomatic HIV+ patients and diminishes the risk of ADC occurrence. Myoinositol and choline levels estimated in 1H MRS might be the indices for antiretroviral treatment efficacy.
Department of Radiology, Medical University, Bialystok, Poland. geno@interia.pl
Eugeniusz
E
Tarasów
Alicja
A
Wiercińska-Drapało
Jerzy
J
Jaroszewicz
Agnieszka
A
Orzechowska-Bobkiewicz
Wojciech
W
Dzienis
Danuta
D
Prokopowicz
Jerzy
J
Walecki
D015526:AIDS Dementia Complex / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male
D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline