AUTHOR=Boban Jasmina M. , Kozic Dusko B. , Brkic Snezana V. , Lendak Dajana F. , Thurnher Majda M. 

TITLE=Early Introduction of cART Reverses Brain Aging Pattern in Well-Controlled HIV Infection: A Comparative MR Spectroscopy Study

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 10 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2018.00329

DOI=10.3389/fnagi.2018.00329

ISSN=1663-4365

ABSTRACT=Introduction: The aim of this study was to compare age-related changes in chronically-infected, asymptomatic HIV-positive patients under combination antiretroviral therapy (cART), with age-, gender- and educational-level-matched healthy subjects, using multi-voxel magnetic resonance spectroscopy (MRS).
Methods: There were 66 chronically infected HIV+ subjects and 65 age-, gender- and educational-level-matched control subjects, divided into four groups according to age: group 1 (20-29 years old), group 2 (30-39), group 3 (40-49) and group 4 (50-59). MRS was performed and ratios of N-acetyl-aspartate (NAA)/creatine (Cr) were analyzed in ten locations of the supracallosal grey matter. For the comparison of NAA/Cr ratios in healthy and HIV-positive subjects, ANCOVA with age and education as covariates was performed. Correlations of NAA/Cr ratios with duration of cART were performed using Pearson's correlation test. Statistical significance was set at p<0.05.
Results: The NAA/Cr ratios were decreased in the 20-29-year-old HIV-positive subjects in 8/10 locations (p<0.005) compared to the healthy controls, while in the 50-59-year-old groups  they were significiantly lower only in one location (p=0.004). There were significant positive correlations of NAA/Cr levels with the duration of cART in the oldest group of HIV-positive subjects, while in the youngest group there were no significant correlations. 
Conclusions: The aging pattern in chronic HIV infection under cART is accentuated rather than accelerated. There is an initial HIV-related neuronal damage with a significant decline in NAA/Cr ratios; after the initiation of cART, however, NAA/Cr ratios increase continuously to become similar to healthy aging individuals, probably due to beneficial effect of long-standing cART.