Deteriorating effects of cocaine abuse on brain metabolic function of HIV infected patients

1849 Objectives HIV infection is a major health problem around the world. HIV infected patients, even if they have an undetectable HIV viral load because of treatment, suffer from cognitive, psychological, and behavioral disorders which affect brain metabolic function. Cocaine use is frequent among HIV infected individuals. Cocaine has destructive effect on the patients’ health and influences brain activity independently. In this study, we wanted to evaluate the effects of well controlled HIV infection and cocaine on brain metabolic function in patients with HIV. Methods Thirty six well controlled HIV infected patients were recruited prospectively into two groups of cocaine abusers and non-cocaine abusers with 18 in each group. Active cocaine use was defined according to DSM-5. The brain metabolic function was assessed by measuring the 18-Fluorodeoxyglucose (FDG) uptake activity in brain (entire brain and cortex) two hours after injecting FDG. The FDG level in target organ was measured by an adaptive threshold imaging software and recorded as global indices for entire brain and cortex separately and was compared between the two groups. Results There were 14 males and 4 females in each group and the mean age was 47.55±7.54 and 48.38±7.92 years for cocaine abusers and non-cocaine abusers, respectively. Compared to cocaine negative group, HIV patients with cocaine addiction tended to have lower global FDG uptake of entire brain (6601.41±1550.33 gr vs. 7793.61±1978.01, P=0.054) and cortex (5879.63±1453.07 Vs. 6911.07±1661.97, P=0.058). Conclusions FDG uptake is an accurate indicator of the brain metabolic function. Brain functioning disorders usually result in decreased brain metabolic function which is detectable by FDG-PET/CT scan. The neuropsychological, behavioral, and neurocognitive disorders are still significant in HIV infected patients regardless of noticeable improvements in HIV treatments. These disorders cause changes in brain metabolic function and may be exacerbated by cocaine abuse. The effects of HIV and cocaine associated brain disorders are additive and result in decreased brain metabolic function detected by FDG-PET/CT scan. Cocaine abuse was associated with lower brain metabolism and may lead to more severe brain function abnormalities in HIV infected patients.