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Abstract #1977

ARV-Mediated Changes in Viral Levels and Neuroaxonal Function Precede Improvements in Cognition in Chronically HIV-Infected Subjects.

Margaret R. Lentz1, Mona A. Mohamed2,3, Hyun Kim1, Jennifer A. Short1, Mahaveer N. Degaonkar2, Elkan Halpern1, Katherine Conant4, Ned Sacktor5, Ola Selnes5, Peter B. Barker2,3, Martin G. Pomper2

1Department of Neuroradiology/A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; 2Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, United States; 3F. M. Kirby Center for Functional Brain Imaging/Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, United States; 4Department of Neuroscience, Georgetown University Medical Center, Washington, DC, United States; 5Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD, United States


The application of combined antiretroviral (ARV) therapy has been shown to change viral and immune signaling kinetics, indicating that correlations between these and MR measures observed in cross-sectional studies may not last. MRSI, global deficit scorings (GDS) and CSF HIV RNA levels of 51 chronically HIV-infected subjects examined over 10 months of a new ARV administration were included in this study. Mixed model regression analysis indicated that later improvements in subjects GDS were associated with earlier improvements in neuroaxonal function and CSF viral load, suggesting that ARV-mediated decreases in CSF viral levels and neuroaxonal recovery precede improvements in cognitive functioning.