Modern medicine can treat HIV, but the disease can still persist in the brain and cause cognitive problems in up to half of patients.

Researchers at the University College of London have developed a way to use MR imaging to identify HIV patients with this particular condition.

Approximately 36.7 million people worldwide were living with HIV/AIDS at the end of 2015, according to AIDS.gov. As of June 2016, 18.2 million people with the disease had access to antiretroviral therapy (ART), which was up from 15.8 the previous year.
To diagnose HIV patients with cognitive problems, a needle is inserted into the back to draw out spinal fluid and test it for HIV. It’s an invasive procedure that requires the patient to remain in the hospital for several hours.

"MRI scans can help to diagnose these patients, whether showing an elevated risk of HIV-related problems or finding a different cause that can then be treated,” Ravi Gupta senior author of the study published in Clinical Infectious Diseases, said in a statement.

Gupta and his team evaluated data from a single laboratory that served a population of 3,800 HIV patients in 2013. By 2015, that number grew to 4,500 patients, and 95 percent of them were receiving ART.

For the study, the team focused on the 146 HIV patients who were examined for cognitive problems between October 2011 and April 2015. They found that the disease was active in the brains of 15 percent or 22 of the patients.

Those with definite signs of change in the brain white matter were ten times more likely to have HIV in the brain than those with normal white matter. Those changes are called diffuse white matter signal abnormalities, and can be triggered by HIV-related inflammation.

Gupta explained that the treatment regime can be changed to add drugs that are capable of crossing the blood-brain barrier more effectively to control the infection. But more longitudinal studies will need to be conducted to further evaluate the connection between HIV and cognitive problems.

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