2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Imaging studies show damaged integrity linked to inflammation Further linked to cognitive impairment

 MCP-1 and neopterin broadly linked to abnormal brain integrity by diffusion tensor imaging (DTI)  These DTI abnormalities link to worse cognitive performance

1.Chang etal, JAIDS2019

Slide 13of46FromVValcour,MD,PhDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

The Role of Cerebrovascular Disease

Slide 14of46FromVValcour,MD,PhDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

Small Vessel Ischemic Disease in HIV

Mild Moderate Severe

• Autopsy series in the US between 1999 to 2011

50 % of cases

SoontornniyomkijetalAIDS2014

Slide 15of46FromVValcour,MD,PhDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.