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Metabolic Asymmetries in Asymptomatic HIV-1 Seropositive Subjects: Relationship to Disease Onset and MRI Findings

Wien Center for Alzheimer's Disease and Memory Disorders, Department of Research, and Department of Radiology, Mount Sinai Medical Center, Miami Beach, Florida
Department of Neurology, Department of Radiology, and Department of Psychiatry, University of Miami School of Medicine, Miami, Florida

Correspondence: For reprints contact: Ranjan Duara, MD, Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, 4300 Alton Rd., Miami Beach, FL 33140.

ABSTRACT

Fifteen male homosexual subjects (mean age 31 .6 ± 7.2 yr) who were asymptomatic, but HIV-1 seropositive (HIV⁺) were compared to 15 male age-matched HIV-1 seronegative (HIV^–) subjects using resting PET/FDG studies and MR scans. Mean cerebral metabolic rates for glucose (mg/100 g/min) in the HIV⁺ and HIV^– subjects were 7.7 ± 1.7 and 7.0 ± 2.1, (p = 0.44), respectively. An index of regional metabolic asymmetry for the whole brain was 5.8% ± 3.2% in the HIV⁺ and 2.7% ± 2.3% in the HIV^– (p = 0.002), and the difference was most prominent in the prefrontal area. Significant asymmetries were found in 10/15 HIV⁺ subjects, primarily in prefrontal (7/15) and premotor (4/15) regions. MRI scans showed no abnormalities on clinical or quantitative evaluation in HIV⁺ subjects. Upon follow-up of HIV⁺ subjects over 18–40 mo, seven became symptomatic, of which two died. There was no relationship between the presence of PET scan abnormalities and earlier onset of symptomatic disease.

FOOTNOTES

^* Current address: Tokai University Hospital Bohseidai, Isehara, Japan.

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