An individual with human immunodeficiency virus, dementia, and central nervous system amyloid deposition

Abstract Human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) is found in 30%–50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV+ individual with HAND. Clinical and neuropsychol...

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Bibliographic Details
Published in:Alzheimer's & dementia : diagnosis, assessment & disease monitoring assessment & disease monitoring, 2016, Vol.4 (1), p.1-5
Main Authors: Turner, Raymond Scott, Chadwick, Melanie, Horton, Wesley A, Simon, Gary L, Jiang, Xiong, Esposito, Giuseppe
Format: Article
Language:English
Subjects:
Age
Aging
Alzheimer's disease
Amyloid PET
Biomarker
Biomarkers
Brain
Cognitive ability
Dementia
Diagnostic Assessment & Prognosis
Fainting
Functional MRI
HAND
HIV
HIV-associated neurocognitive disorder
Human immunodeficiency virus
Immune system
Infections
Neurology
Other
Proteomics
Sleep
Substance abuse treatment
Viral infections
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Summary:Abstract Human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) is found in 30%–50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV+ individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose–PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Aβ42/tau index but a low phospho-tau. An amyloid PET/CT with [18F]florbetaben revealed pronounced cortical radiotracer deposition. This case report suggests that progressive dementia in older HIV+ individuals may be due to HAND, AD, or both. HIV infection does not preclude CNS Aβ/amyloid deposition. Amyloid PET imaging may be of value in distinguishing HAND from AD pathologies.
ISSN:2352-8729
2352-8729
DOI:10.1016/j.dadm.2016.03.009