Cerebral single-photon emission computed tomography abnormalities in human immunodeficiency virus type 1-infected gay men without cognitive impairment
N. Sacktor, I. Prohovnik, R. L. Van Heertum, G. Dooneief, J. Gorman, K. Marder, G. Todak, Y. Stern and R. Mayeux
Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA.
OBJECTIVE: To determine whether technetium Tc99m exametazime single-photon
computed emission tomography (SPECT) can distinguish gay human
immunodeficiency virus (HIV)-positive subjects, both with and without mild
cognitive impairment, from gay HIV-negative control subjects. DESIGN:
Twenty HIV-positive subjects (12 without cognitive impairment and eight
with mild cognitive impairment) and 10 HIV-negative subjects underwent
neurological, neuropsychological, magnetic resonance imaging, and
technetium Tc 99m exametazime SPECT examinations. SETTING: Subjects were
recruited from a natural history study of gay men with HIV infection.
PATIENTS: Subjects from the cohort who had previously participated in a
magnetic resonance imaging study were selected for the SPECT study. MAIN
OUTCOME MEASURES: The SPECT scans were rated as abnormal if focal defects,
confirmed by a horizontal profile analysis, were seen. RESULTS: Sixty-seven
percent of HIV-positive subjects without cognitive impairment, 88% of
HIV-positive subjects with mild cognitive impairment, and 20% of
HIV-negative subjects had abnormal SPECT scans (P < .05 for both
HIV-positive groups when each group was compared with HIV-negative
subjects). CONCLUSION: Compared with gay HIV-negative control subjects,
focal SPECT defects are seen with an increased frequency in HIV-positive
gay men without cognitive impairment and in HIV-positive gay men with mild
cognitive impairment.
