EFFECTS OF CHRONIC ALCOHOL-ABUSE AND HIV-INFECTION ON BRAIN PHOSPHORUS METABOLITES

We examined the effects of human immunodeficiency virus (HIV) infectio n and chronic alcohol consumption on cerebral phosphorus metabolites t o determine if chronic alcohol abuse is a risk factor for the progress ion of neurological effects of HIV infection. We studied 15 HIV- alcoh olics, 8 HIV- light/nondrinkers, 32 HIV+ alcoholics, and 41 HIV+ light /nondrinking men, with both HIV+ groups having similar CD4 lymphocyte counts. We used localized 31-phosphorus magnetic resonance spectroscop y after magnetic resonance imaging to examine two brain volumes in sup erior white matter and subcortical gray matter. Chronic alcohol consum ption was associated with reduced white matter concentrations of phosp hodiester (PDE) and phosphocreatine (PCr). Also in the white matter, a cquired immune deficiency syndrome (AIDS) and AIDS-related complex (AR C) were associated with reduced concentrations of PDE and PCr, compare d with both HIV- and clinically asymptomatic HIV+ subjects. Because no alcohol-by-HIV interactions were detected, the effects of HIV infecti on and alcohol abuse were cumulative. This is reflected in a successiv e decrease of white matter PDE and PCr concentrations in the order HIV - light/nondrinkers/H1V- alcoholics/HIV+ light/nondrinkers/HIV+ alcoho lics. Subcortical gray matter PDE concentrations were lower in ARC/AID S alcoholics than in HIV- light/nondrinking individuals. These finding s suggest altered brain phospholipid metabolites and energy metabolite s with alcohol abuse and HIV infection. They demonstrate that the adve rse metabolic effects of HIV on the brain are augmented by chronic alc ohol abuse.