Little is known about the pathology of cerebral white matter injury occurring in HIV. Myelin water imaging quantifies myelin content and results are expressed as myelin water fraction (MWF). We defined the cognitive profile of virally suppressed adults with perinatally acquired HIV (pHIV) and demonstrate the association between MWF and cognition. Ten (58%) adults with pHIV were cognitively impaired. Lower global MWF correlated with worse performance in executive function (r: 0.762, p: 0.037). Cognitive impairment is common among our cohort of adults with virally suppressed pHIV. Decreased myelination occurs in pHIV and may be a pathologic substrate of cognitive impairment.
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