HIV 感染后 100 天内的大脑改变。
Brain alterations within the first 100 days of HIV infection.
机构信息
Department of Radiology, Feinberg School of Medicine, Northwestern University Chicago, Illinois.
Center for Advanced Imaging, NorthShore University Hospital Evanston, Illinois.
出版信息
Ann Clin Transl Neurol. 2015 Jan;2(1):12-21. doi: 10.1002/acn3.136. Epub 2014 Dec 18.
OBJECTIVE
Brain involvement is a serious complication of HIV infection. The earliest changes in the brain, which represents an anatomic site for viral persistence, are largely unknown.
METHODS
This investigation used quantitative Magnetic Resonance methodologies, including high resolution and diffusion tensor (DTI) imaging, to evaluate the brain in 15 HIV and 20 seronegative subjects. All HIV subjects were antibody nonreactive with assay-estimated infection duration of less than 100 days.
RESULTS
Brain volumetric analysis revealed reduced parenchyma with enlargement of the third ventricle and brainstem. DTI quantified loss of white matter integrity in the corpus callosum and diffusion alterations in caudate. Cognitive differences were indicated in psychomotor speed and visual recall. There were no differences between antiretroviral-initiated and naïve HIV subgroups.
INTERPRETATION
These findings, quantified within 100 days of infection, shed light on the earliest brain changes in HIV infection. Onset of neural injury may date to initial viral invasion and the transient early period of unchecked viremia and marked immunosuppression of the seroconversion period.
目的
大脑损伤是 HIV 感染的严重并发症。HIV 持续存在的主要部位——大脑，其早期变化尚不清楚。
方法
本研究使用定量磁共振方法，包括高分辨率和弥散张量成像（DTI），对 15 名 HIV 患者和 20 名血清阴性对照者的大脑进行了评估。所有 HIV 患者抗体反应阴性，检测估计感染时间不到 100 天。
结果
脑容积分析显示实质减少，第三脑室和脑干扩大。DTI 量化了胼胝体白质完整性的丧失和尾状核的弥散改变。在精神运动速度和视觉记忆方面存在认知差异。在开始抗病毒治疗和未开始抗病毒治疗的 HIV 亚组之间没有差异。
结论
这些在感染后 100 天内定量的发现揭示了 HIV 感染早期的大脑变化。神经损伤的发生可能始于最初的病毒入侵，以及血清转化期不受控制的病毒血症和明显的免疫抑制的短暂早期阶段。
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