Objective: 

Despite combined antiretroviral therapy, neuroinflammation may persist in persons living with HIV (PLWH) and contribute to cognitive impairment in this population. Positron emission tomography (PET) imaging targeting 18 kDa translocator protein (TSPO) has been used to localize neuroinflammation. We aimed to use TSPO-PET imaging to evaluate neuroinflammation in PLWH.

Design: 

Twenty-four virologically suppressed PLWH on combined antiretroviral therapy and 13 HIV-negative (HIV−) controls completed TSPO-PET imaging using the radiotracer [¹¹C]PBR28. Because of tracer complexity and differing procedures used in previous studies, we employed an expansive methodological approach, using binding potential (BP) and standard uptake value ratio and multiple different reference regions to estimate [¹¹C]PBR28 binding.

Methods: 

[¹¹C]PBR28 binding was measured in 30 cortical and subcortical regions and compared between PLWH and HIV− controls. Pearson correlation evaluated the association between [¹¹C]PBR28 binding and cognition and clinical measures of HIV.

Results: 

Analyses conducted using multiple reference regions and measures of tracer uptake revealed no significant differences between [¹¹C]PBR28 binding in PLWH compared with HIV− controls. In addition, [¹¹C]PBR28 binding in PLWH was not significantly associated with clinical measures of HIV or plasma biomarkers of inflammation. [¹¹C]PBR28 binding was not significantly elevated in cognitively impaired PLWH compared with unimpaired PLWH, but there were inverse relationships between cognitive performance (executive and global function) and [¹¹C]PBR28 binding in PLWH.

Conclusions: 

Our results suggest that neuroinflammation may play a role in cognitive deficits, but overall neuroinflammatory levels as measured by TSPO-PET imaging in PLWH are not significantly different from those seen in HIV− controls.

中文翻译：

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艾滋病毒感染者与未感染艾滋病毒的人之间[11C] -PBR28结合的比较

目的： 

尽管联合使用了抗逆转录病毒疗法，但艾滋病毒感染者（PLWH）可能仍会出现神经炎症，并导致该人群的认知障碍。针对18 kDa易位蛋白（TSPO）的正电子发射断层扫描（PET）成像已用于定位神经炎症。我们旨在使用TSPO-PET成像来评估PLWH中的神经炎症。

设计： 

联合抗逆转录病毒疗法有24例病毒学抑制的PLWH和13例HIV阴性（HIV-）对照者使用放射性示踪剂[ ¹¹ C] PBR28完成了TSPO-PET成像。由于示踪剂的复杂性和先前研究中使用的不同程序，我们采用了一种扩展的方法学方法，使用结合电位（BP）和标准摄取值比率以及多个不同的参考区域来估计[ ¹¹ C] PBR28结合。

方法： 

在30个皮质和皮质下区域测量[ ¹¹ C] PBR28结合，并在PLWH和HIV-对照之间进行比较。皮尔森相关性评估了[ ¹¹ C] PBR28结合与认知与HIV的临床检测之间的关联。

结果： 

使用多个参考区域进行的分析以及示踪剂摄取的测量表明，与HIV-对照相比，PLWH中的[ ¹¹ C] PBR28结合之间没有显着差异。此外，PLWH中的[ ¹¹ C] PBR28结合与HIV的临床测量或炎症的血浆生物标志物没有显着相关。与未受损的PLWH相比，在认知受损的PLWH中[ ¹¹ C] PBR28的结合没有显着提高，但是在PLWH中，认知表现（执行和整体功能）与[ ¹¹ C] PBR28的结合之间存在反比关系。

结论： 

我们的研究结果表明，神经炎症可能在认知缺陷中起作用，但是通过TSPO-PET成像在PLWH中测得的总体神经炎症水平与在HIV-对照中所见的水平没有显着差异。