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Study finds subtle brain damage in some HIV patients on drug therapy

Researchers have found subtle damage in the brains of HIV-positive patients whose viral load is effectively suppressed by anti-retroviral therapy. In one of the first studies of its kind, researchers from the San Francisco Veterans Affairs Medical Center (SFVAMC) used a combination of MRI brain imaging, recording of electrical brain activity, and behavioral tests to compare the size and function of brains of HIV-positive patients on antiretroviral therapy with those of healthy subjects.

Although it is not known whether any or all of the damage occurred before patients started drug therapy, even minor damage that is present now should serve as a warning, says Linda Chao, PhD, the study's lead author and an assistant adjunct professor with the Magnetic Resonance Unit of the SFVAMC and the Departments of Psychiatry and Radiology at University of California, San Francisco (UCSF). "People are starting to get lax about AIDS now," Chao says. "You see people on antiretroviral medications and they seem fine. But the take-home message of our study is that antiviral medications might not be stopping brain damage. When we put patients' brains under closer scrutiny, we saw that they were affected."

"The results of our study raise the concern of brain injury in HIV subjects who are on treatment, even among those who are virally suppressed," says the study's senior investigator, Michael Weiner, MD, of the Magnetic Resonance Unit, SFVAMC, and the Departments of Radiology, Psychiatry, Medicine and Neurology at UCSF. "What we don't know is whether or not these changes occurred some time ago, prior to effective treatment, or whether these changes represent ongoing injury."

The study appears in the November 14 issue of NeuroReport. HIV or human immunodeficiency virus, the pathogen that causes AIDS or acquired immunodeficiency syndrome, can produce neurological abnormalities in any part of the nervous system, including the brain. Symptoms of HIV brain damage ma
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Contact: Liese Greensfelder
lgreensfelder@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
13-Nov-2003


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