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Age\u2010 and sex\u2010matched controls underwent single MR measurements. Regional CBF and rCMRO<jats:sub>2<\/jats:sub> were compared amongst symptomatic, asymptomatic, normal HAND and controls using analysis of variance. Longitudinal analysis of HAND worsening (\u22651 category) was assessed after 12 months of ART and correlated with rCBF and rCMRO<jats:sub>2<\/jats:sub> measured by MR imaging using the paired\u2010sample <jats:italic>t<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty PLHIV completed baseline and 12\u2010month assessments (29 with rCMRO<jats:sub>2<\/jats:sub> measurement). At baseline HAND assessment, 13% had no cognitive impairment, 27% had asymptomatic neurocognitive impairment, 60% had mild neurocognitive disorder and none had HIV\u2010associated dementia. At 12\u00a0months, 13% had no cognitive impairment, 20% had asymptomatic neurocognitive impairment, 50% had mild neurocognitive disorder and 17% had HIV\u2010associated dementia. In those without HAND worsening (<jats:italic>N<\/jats:italic>\u00a0=\u00a021) rCMRO<jats:sub>2<\/jats:sub> remained stable and in those with HAND worsening (<jats:italic>N<\/jats:italic>\u00a0=\u00a08) rCMRO<jats:sub>2<\/jats:sub> measurement declined from baseline to 12 months in white matter (2.05\u00a0\u00b1\u00a00.40 to 1.73\u00a0\u00b1\u00a00.51, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and lenticular nuclei (4.32\u00a0\u00b1\u00a00.39 to 4.00\u00a0\u00b1\u00a00.51, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In recently diagnosed PLHIV, no association was found between rCBF or rCMRO<jats:sub>2<\/jats:sub> and cognitive impairment at baseline. There was a reduction in rCMRO<jats:sub>2<\/jats:sub> in those with worsening of cognitive function at 12\u00a0months on ART. Reduction in rCMRO<jats:sub>2<\/jats:sub> may be a biomarker of cognitive decline in PLHIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15196","type":"journal-article","created":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T16:40:58Z","timestamp":1637858458000},"page":"1062-1074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reduction in cerebral oxygen metabolism in subcortical regions may be a biomarker of cognitive decline in people living with human immunodeficiency virus"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-2364","authenticated-orcid":false,"given":"Souvik","family":"Sen","sequence":"first","affiliation":[{"name":"Prisma Health\/University of South Carolina Columbia South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyu","family":"An","sequence":"additional","affiliation":[{"name":"Washington University Saint 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