Neuroimaging correlates of HIV-associated BBB compromise

Malcolm J. Avison, Avindra Nath, Robin Greene-Avison, Frederick A. Schmitt, Richard N. Greenberg, Joseph R. Berger

Research output: Contribution to journalArticle

Abstract

The mechanisms underlying blood-brain barrier (BBB) compromise in human immunodeficiency virus (HIV) infection and the ways in which BBB compromise might impair neurocognitive function remain poorly understood. This study had two aims: (1) to examine the relationship between BBB breakdown, measured using contrast-enhanced magnetic resonance imaging (CE-MRI), plasma viral load, and neurological status; and (2) to examine the influence of highly active antiretroviral therapy (HAART) on the relationship between neuroinflammation using myoinositol/creatine (mI/Cr), a surrogate marker of glial activation as measured by magnetic resonance spectroscopy (MRS), and BBB compromise determined by CE-MRI. In 25 HIV-infected patients, we found that: (1) the severity of neurocognitive impairment correlated with the degree of BBB breakdown in the basal ganglia; (2) for any given degree of BBB compromise, patients with high plasma viral load were more severely impaired; (3) BBB compromise correlated with mI/Cr in the basal ganglia; and (4) for any given level of mI/Cr, the severity of BBB compromise and the severity of neurocognitive impairment were significantly less in patients on HAART than in those who were HAART-naïve. These results confirm a role for BBB compromise in the pathogenesis of HIV-associated neurocognitive impairment and suggest that elevated plasma viral load in the presence of BBB compromise may increase the risk for development of HIV-associated dementia (HAD). Additionally, they suggest a salutary effect of HAART on the incidence and severity of HAD, which may, in part, be due to protection of BBB integrity.

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalJournal of Neuroimmunology
Volume157
Issue number1-2 SPEC. ISS.
DOIs
StatePublished - Dec 2004

Fingerprint

Blood-Brain Barrier
Neuroimaging
HIV
Highly Active Antiretroviral Therapy
Creatine
Inositol
Viral Load
Basal Ganglia
Magnetic Resonance Imaging
AIDS Dementia Complex
Virus Diseases
Neuroglia
Dementia
Magnetic Resonance Spectroscopy
Biomarkers
Incidence

Keywords

  • BBB compromise
  • HIV-associated
  • Neuroimaging

ASJC Scopus subject areas

  • Immunology
  • Clinical Neurology
  • Immunology and Allergy
  • Neurology

Cite this

Avison, M. J., Nath, A., Greene-Avison, R., Schmitt, F. A., Greenberg, R. N., & Berger, J. R. (2004). Neuroimaging correlates of HIV-associated BBB compromise. Journal of Neuroimmunology, 157(1-2 SPEC. ISS.), 140-146. https://doi.org/10.1016/j.jneuroim.2004.08.025

Neuroimaging correlates of HIV-associated BBB compromise. / Avison, Malcolm J.; Nath, Avindra; Greene-Avison, Robin; Schmitt, Frederick A.; Greenberg, Richard N.; Berger, Joseph R.

In: Journal of Neuroimmunology, Vol. 157, No. 1-2 SPEC. ISS., 12.2004, p. 140-146.

Research output: Contribution to journalArticle

Avison, MJ, Nath, A, Greene-Avison, R, Schmitt, FA, Greenberg, RN & Berger, JR 2004, 'Neuroimaging correlates of HIV-associated BBB compromise', Journal of Neuroimmunology, vol. 157, no. 1-2 SPEC. ISS., pp. 140-146. https://doi.org/10.1016/j.jneuroim.2004.08.025
Avison MJ, Nath A, Greene-Avison R, Schmitt FA, Greenberg RN, Berger JR. Neuroimaging correlates of HIV-associated BBB compromise. Journal of Neuroimmunology. 2004 Dec;157(1-2 SPEC. ISS.):140-146. https://doi.org/10.1016/j.jneuroim.2004.08.025
Avison, Malcolm J. ; Nath, Avindra ; Greene-Avison, Robin ; Schmitt, Frederick A. ; Greenberg, Richard N. ; Berger, Joseph R. / Neuroimaging correlates of HIV-associated BBB compromise. In: Journal of Neuroimmunology. 2004 ; Vol. 157, No. 1-2 SPEC. ISS. pp. 140-146.
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