Letendre SL, McCutchan JA, Ellis RJ, Chopra S, Abdi RF, Masliah E, Wiley CA, Hesselink JR; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 6th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 6th 1999 Chic Ill. 1999 Jan 31-Feb 4; 6th: 145 (abstract no. 414).

University of California, San Diego.

Background: CMV retinitis (CMV-R) is readily diagnosed in AIDS patients and is frequently associated with CMV-E at autopsy. However, CMV-E is clinically underrecognized. Enhanced signal in the fornix on T2-weighted brain magnetic resonance (MR) scans is found in some patients with AIDS and CMV-E and is referred to as the FWL. Methods: Cases with AIDS and CMV-R (N=30) were matched by age, gender, education, and blood CD4 counts to HIV-infected controls without CMV-R (N=76). All subjects had 2 cranial MR scans. Most (N=74) were assigned consensus neurocognitive diagnoses based on standardized neuropsychological (NP) and neuromedical exams. A subset (N=31) also had neuropathological studies performed at autopsy. A masked neuroradiologist rated MR scans for the presence and intensity of the FWL. Results: The FWL was present on 30/106 (28%) initial MR scans. 15/30 (50%) cases and 15/76 (20%) controls had the FWL [OR=4.1 (95% CI 1.6-10.3)]. The FWL was at least moderately intense in 6/30 cases (21%) and 4/76 controls (5%) [OR=4.5 (95% CI 1.2-19)]. Those with moderate to severe NP impairment were more likely to have the FWL [OR=6.5 (95% CI: 1.9-24)].CMV-E was found at autopsy in 10/31 (32%) subjects. A FWL of at least moderate intensity was present on the final MR scan in 5/10 (50%) subjects with CMV-E at autopsy but only 2/21 (9.5%) subjects without it [OR=9.5 (95%CI 1.6-82)]. Conclusions: The FWL is more frequent in patients with AIDS and CMV-R and is associated with both NP impairment in life and CMV-E at autopsy. The FWL in subjects with CMV-R may be an early manifestation of CMV-E, which leads to cognitive impairment.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Autopsy
• Brain
• Case-Control Studies
• Cytomegalovirus Infections
• Cytomegalovirus Retinitis
• Encephalitis, Viral
• Fornix, Brain
• HIV Infections
• Humans
• Magnetic Resonance Spectroscopy

Other ID:

• 20711653

UI: 102195183

From Meeting Abstracts