title: Cerebral signal intensity abnormalities on T2-weighted MR images in HIV patients with highly active antiretroviral therapy: relationship with clinical parameters and interval changes.
abstract: OBJECTIVE
  The aim of this study was to assess the relationship between immune state and cerebral signal intensity abnormalities (SIAs) on T2-weighted magnetic resonance images in subjects with human immunodeficiency virus type 1 infection and highly active antiretroviral therapy.
  
  
  METHODS
  Thirty-two subjects underwent a total of 109 magnetic resonance studies. The presence of human immunodeficiency virus-associated neurocognitive disorder, categorized CD4(+) T lymphocyte count, and plasma viral load were assessed for relationship with the severity and interval change of SIAs for different anatomic locations of the brain.
  
  
  RESULTS
  Subjects with multifocal patterns of SIAs had CD4(+) cell counts < 200 cells/μL in 66.0%, whereas subjects with diffuse patterns of SIAs had CD4(+) cell counts < 200 cells/μL in only 31.4% (P < .001). Subjects without SIAs in the basal ganglia had CD4(+) cell counts < 200 cells/μL in 37.0%, whereas subjects with minor and moderate SIAs in the basal ganglia had CD4(+) cell counts < 200 cells/μL in 78.3% and 80.0%, respectively (P < .005). The percentage of subjects with CD4(+) cell counts < 200 cells/μL was 85.7% when there were progressive periventricular SIA changes and 45.5% when periventricular SIA changes were stable in follow-up (P < .05).
  
  
  CONCLUSIONS
  The presence and progression of cerebral SIAs on T2-weighted magnetic resonance images reflecting cerebral infection with human immunodeficiency virus are significantly related to impaired immune state as measured by CD4(+) cell count.
authors.affiliation: Department of Clinical Radiology, University of Münster, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Hanning
authors.forename: Ingo W
authors.initials: IW
authors.lastname: Husstedt
authors.forename: Thomas-Ulrich
authors.initials: TU
authors.lastname: Niederstadt
authors.forename: Stefan
authors.initials: S
authors.lastname: Evers
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.forename: Stephan P
authors.initials: SP
authors.lastname: Kloska
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000473:pathology*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D015497:HIV-1; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019562:Viral Load