title: A prospective radiologic and neurologic follow-up study of 61 HIV-1 -infected subjects: early beginning and slow progression of brain atrophy.
abstract: The course of the organic brain disease caused by human immunodeficency virus (HIV-1) was evaluated in a follow-up study. The primary material included 200 consecutive HIV-1 infected persons. Sixty-one subjects, in whom other brain-affecting factors were excluded, consented to the follow-up. They underwent 278 radiologic examinations: computed tomography, magnetic resonance imaging, or a combination of both (mean 4.6 examinations/subject). Clinical neurologic status and, in 40 subjects, cognitive performance were repeatedly evaluated. Sixteen subjects were followed up until death and 11 of them were autopsied. Median follow-up time was 27 mo (range 2.5-66 mo). The most common radiologic finding was atrophy, found in 19 subjects at study entry and developing in 10 subjects during the study. Twenty-four subjects (39%) showed the development and/or progression of atrophy. Atrophic changes progressed most rapidly in acquired immunodeficiency syndrome (AIDS), but mild developing/progressive atrophy was found even in 33% of asymptomatic or neurologically intact subjects. Cognitive and radiologic worsening were simultaneous in 6/7 subjects with declining neuropsychologic test performance. Signal intensity changes including HIV-1 leukoencephalopathy appeared in AIDS patients with clear cognitive decline.
authors.affiliation: Department of Radiology, University Central Hospital of Helsinki, Helsinki, FinlandDepartment of Neurology, Tampere University Hospital, Tampere, FinlandDepartment of Infectious Diseases, Aurora Hospital, Helsinki, FinlandDepartment of Neurology, University of Helsinki, Helsinki, FinlandDepartment of Radiology, Kivelä Hospital, Helsinki, FinlandDepartment of Pathology, University of Helsinki, Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Raininko
authors.forename: I
authors.initials: I
authors.lastname: Elovaara
authors.forename: E
authors.initials: E
authors.lastname: Poutiainen
authors.forename: A
authors.initials: A
authors.lastname: Virta
authors.forename: L
authors.initials: L
authors.lastname: Valanne
authors.forename: M
authors.initials: M
authors.lastname: Haltia
authors.forename: J
authors.initials: J
authors.lastname: Lähdevirta