title: Change in brain magnetic resonance spectroscopy after treatment during acute HIV infection.
abstract: OBJECTIVE
  Single voxel proton magnetic resonance spectroscopy (MRS) can be used to monitor changes in brain inflammation and neuronal integrity associated with HIV infection and its treatments. We used MRS to measure brain changes during the first weeks following HIV infection and in response to antiretroviral therapy (ART).
  
  
  METHODS
  Brain metabolite levels of N-acetyl aspartate (NAA), choline (tCHO), creatine (CR), myoinositol (MI), and glutamate and glutamine (GLX) were measured in acute HIV subjects (n = 31) and compared to chronic HIV+individuals (n = 26) and HIV negative control subjects (n = 10) from Bangkok, Thailand. Metabolites were measured in frontal gray matter (FGM), frontal white matter (FWM), occipital gray matter (OGM), and basal ganglia (BG). Repeat measures were obtained in 17 acute subjects 1, 3 and 6 months following initiation of ART.
  
  
  RESULTS
  After adjustment for age we identified elevated BG tCHO/CR in acute HIV cases at baseline (median 14 days after HIV infection) compared to control (p = 0.0014), as well as chronic subjects (p = 0.0023). A similar tCHO/CR elevation was noted in OGM; no other metabolite abnormalities were seen between acute and control subjects. Mixed longitudinal models revealed resolution of BG tCHO/CR elevation after ART (p = 0.022) with tCHO/CR similar to control subjects at 6 months.
  
  
  CONCLUSIONS
  We detected cellular inflammation in the absence of measurable neuronal injury within the first month of HIV infection, and normalization of this inflammation following acutely administered ART. Our findings suggest that early ART may be neuroprotective in HIV infection by mitigating processes leading to CNS injury.
authors.affiliation: Huntington Medical Research Institutes, Pasadena, CA, USA.
authors.forename: Napapon
authors.initials: N
authors.lastname: Sailasuta
authors.forename: William
authors.initials: W
authors.lastname: Ross
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Thep
authors.initials: T
authors.lastname: Chalermchai
authors.forename: Victor
authors.initials: V
authors.lastname: DeGruttola
authors.forename: Sukalaya
authors.initials: S
authors.lastname: Lerdlum
authors.forename: Mantana
authors.initials: M
authors.lastname: Pothisri
authors.forename: Edgar
authors.initials: E
authors.lastname: Busovaca
authors.forename: Silvia
authors.initials: S
authors.lastname: Ratto-Kim
authors.forename: Linda
authors.initials: L
authors.lastname: Jagodzinski
authors.forename: Serena
authors.initials: S
authors.lastname: Spudich
authors.forename: Nelson
authors.initials: N
authors.lastname: Michael
authors.forename: Jerome H
authors.initials: JH
authors.lastname: Kim
authors.forename: Victor
authors.initials: V
authors.lastname: Valcour
mesh_terms: D000208:Acute Disease; D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000187:drug effects / Q000473:pathology; D011786:Quality Control; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents