Despite advances in medications and modern practices of immediate antiretroviral therapy, chronic HIV infection remains associated with brain insults, cognitive decline, and related neurological disorders. Reduced N-acetyl-aspartete (NAA), a metabolic marker of neuronal injury, was associated with advanced age and lower CD4 nadir count in a chronic, asymptomatic HIV cohort. Using a novel, BOLD MR protocol incorporating hypercapnic and hyperoxic stimuli, NAA showed no relation to cerebrovascular reactivity (CVR) but was significantly correlated to cerebral blood volume (CBV). Our results may indicate future use of NAA and CBV as complementary non-invasive metrics to track brain health in HIV.
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