The review looked at studies using brain imaging techniques called EEG and MEG to understand how HIV affects the brain. They found that people with HIV showed differences in brain activity compared to those without the infection, even when their HIV was well controlled with medication. These brain changes were linked to cognitive abilities in HIV patients. EEG and could potentially be used as biomarkers to detect brain dysfunction in people with HIV, but more research is needed to confirm their usefulness.
The Human Immunodeficiency Virus (HIV) has an impact on the brain, even when the infection is well-controlled with modern highly-active antiretroviral therapy (HAART). While dementia is rare in those on HAART, milder cognitive impairment is common. The causes, patterns, and evolution of brain dysfunction in people living with HIV remain uncertain. We evaluate whether electrophysiological methods provide informative measures of brain dysfunction in this population.
A systematic literature search identified studies that used EEG or MEG to evaluate persons living with HIV published between 1996 (when HAART became available) and 2016.
Twenty-eight studies were identified. Most involved small samples, and all but four were cross-sectional. Reduced amplitude of Event Related Potentials and decreased power in the alpha band at rest were the most frequent differences between people with and without HIV infection. Of the 16 studies that also assessed cognitive ability, 13 found a significant relationship between cognition and electrophysiological changes in the HIV+ groups. Five of those studies also reported a significant relationship with current immunosuppression, suggesting a direct effect of HIV on the brain. There were few longitudinal studies; whether these electrophysiological changes progress over time, or respond to treatment, remains unclear.
EEG and MEG can provide useful information about brain dysfunction in people with HIV infection, but more consistent assessments of both cognition and EEG patterns, as well as longitudinal studies with larger, better characterized samples are needed.
This is the first systematic review of electrophysiological findings in HIV since the availability of HAART. EEG and MEG measures are sensitive to brain dysfunction in this population, and could complement other approaches in improving the assessment, understanding and treatment of neurocognitive disorders in HIV.
Open Access: PDF of original journal article