Neurovascular Magnetic Resonance Imaging in the Assessment of HIV-Associated Neurocognitive Disorders

Fecha de inicio: 13 de septiembre de 2012

INCLUSION CRITERIA: Inclusion criteria for all participants: Age 25-61 years. Willingness to allow stored samples, human leukocyte antigen (HLA) testing, and future genetic testing. Hemoglobin less than or equal to 9.0 g/dL, HCT less than or equal to 28%, platelets less than or equal to 50,000/microL. English language fluency (required for neuropsychological testing). Additional inclusion criteria for HIV+ participants: Documented HIV infection by standard HIV testing. Prior documentation of HIV- antibody status at the NIH will be accepted in lieu of repeat testing. HIV viral load below the limit of detection on combination antiretroviral therapy for less than or equal to 1 year. Under the care of a primary care physician. Additional inclusion criteria for HIV-negative participants: 1. HIV-antibody negative. EXCLUSION CRITERIA: Exclusion criteria for all participants: Contraindication to MRI scanning, including pacemakers or other implanted electrical devices, brain stimulators, some types of dental implants, aneurysm clips (metal clips on the wall of a large artery), metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pump, or shrapnel fragments. Subjects with a condition precluding entry into scanner and acquisition of scans (e.g., morbid obesity, claustrophobia, back pain, motion disorders). Glomerular filtration rate <45 mL/min/1.73 m(2) as estimated using the Modified Diet in Renal Disease equation. Allergy to qadolinium (MRI contrast) Evidence of current or prior central nervous system opportunistic infection(s) and/or space-occupying lesions such as primary CNS lymphoma. Prior history of intrathecal chemotherapy or radiation therapy to the brain. History of or current diagnosis of systemic vasculitis. Active systemic infection or malignancy requiring therapy. Psychiatric condition interfering with ability to participate in study procedures or provide informed consent. Patient or provider report of alcohol or drug abuse ongoing or within 3 months prior to participation. Sickle cell disease (due to known association with vasculopathy). Systolic blood pressure less than or equal to 180 mmHg at screening. Persons infected with hepatitis C virus (HCV) who are being treated or planning to seek treatment for HCV. Women who are lactating, pregnant, or actively seeking to become pregnant. Other known clinical condition or conditions discovered on MRI that, at the discretion of the investigators, precludes serial clinical, neuropsychological, or imaging evaluation. Additional exclusion criteria for HIV+ participants 1. HIV acquired perinatally (due to potential effects of HIV and antiretroviral therapy on neurocognitive and vascular development).