Increased Cortical Cerebral Blood Flow in Asymptomatic Human Immunodeficiency Virus-Infected Subjects

J Stroke Cerebrovasc Dis. 2016 Aug;25(8):1891-5. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.045. Epub 2016 May 5.


Background: Human immunodeficiency virus (HIV)-infected individuals are at high risk for ischemic stroke. To investigate the physiological basis for this risk, we used magnetic resonance imaging (MRI) to measure oxygen extraction fraction (OEF) and cerebral blood flow (CBF) in treatment-naive asymptomatic HIV-infected subjects and controls.

Methods: In treatment-naive asymptomatic HIV-infected subjects and age-, gender-, and race-matched controls, OEF was measured by MRI asymmetric spin-echo echo-planar imaging sequences and CBF was measured by MRI pseudocontinuous arterial spin labeling.

Results: Twenty-six treatment-naive HIV-infected subjects and 27 age-, gender-, race-matched controls participated. Whole-brain, gray matter (GM), and white matter OEF were not different between the groups (all P > .70). Unexpectedly, HIV-infected subjects had significantly higher CBF in cortical GM (72.9 ± 16.2 mL/100 g/min versus 63.9 ± 9.9 mL/100 g/min; P = .01) but not in subcortical GM (P = .25).

Conclusions: The observed increase in cortical GM CBF in treatment-naive HIV-infected subjects is unexpected, contrary to CBF decreases reported in HIV-infected subjects on treatment, and may represent an initial increase in metabolic activity due to an HIV-mediated inflammation.

Keywords: Cerebral blood flow measurement; MRI; cerebrovascular disease; infectious disease; inflammation.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Case-Control Studies
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / pathology*
  • Cerebral Cortex / virology
  • Cerebrovascular Circulation / physiology*
  • Female
  • Glafenine / administration & dosage
  • Glafenine / analogs & derivatives
  • HIV Infections / diagnostic imaging
  • HIV Infections / drug therapy
  • HIV Infections / pathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Spin Labels
  • Young Adult


  • Anti-Retroviral Agents
  • Spin Labels
  • Glafenine
  • nicafenine