학술논문

Cerebral vasoreactivity is impaired in treated, virally suppressed HIV-infected individuals
Document Type
article
Source
AIDS. 30(1)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Immunology
Infectious Diseases
Brain Disorders
Stroke
Clinical Research
Neurosciences
HIV/AIDS
Infection
Adult
Aged
Anti-Retroviral Agents
Cerebrovascular Disorders
Cross-Sectional Studies
Female
HIV Infections
Humans
Male
Middle Aged
cerebral vasoreactivity
cerebrovascular disease
endothelial function
HIV
stroke
transcranial Doppler
treatment
Biological Sciences
Medical and Health Sciences
Psychology and Cognitive Sciences
Virology
Biomedical and clinical sciences
Health sciences
Language
Abstract
ObjectiveTo compare cerebral vasoreactivity, a measure of cerebrovascular endothelial function, between treated, virally suppressed HIV-infected individuals and HIV-uninfected controls and to evaluate the effect of HIV-specific factors on cerebral vasoreactivity.MethodsCross-sectional study of 65 antiretroviral therapy-treated, virally suppressed HIV-infected individuals and 28 HIV-uninfected controls. Participants underwent noninvasive assessment of cerebral vasoreactivity using transcranial Doppler ultrasound and inhaled carbon dioxide (CO2). We used mixed effects multivariable linear regression to determine the association of HIV infection and HIV-specific factors with cerebral vasoreactivity.ResultsMean age was 57.2 years for HIV-infected participants and 53.5 years for HIV-uninfected controls. Most participants (95%) were men. Twenty-six per cent of HIV-infected participants were nonwhite compared to 32% of controls. Among HIV-infected participants, mean CD4 cell count was 596 cells/μl, and mean duration of viral suppression was 7.8 years. Cerebral vasoreactivity in response to hypercapnia (cerebral VRhyper) was lower in HIV-infected individuals compared to uninfected controls (3.23 versus 3.81%, P = 0.010). After adjusting for demographic and vascular risk factors, HIV infection was independently associated with lower cerebral vasoreactivity (-0.86%, 95% CI -1.30 to -0.42%, P