Plasma Cystatin C Associates With HIV-Associated Neurocognitive Disorder but Is a Poor Diagnostic Marker in Antiretroviral Therapy–Treated Individuals
Year: 2019
Type: article
Abstract: OBJECTIVE: To examine associations between plasma cystatin C and neurocognitive impairment (NCI) and its performance as a diagnostic marker before and during initial antiretroviral therapy (ART). METHODS: Multivariable logistic regression and generalized estimating equations examined associations with NCI, determined by neuropsychological measurements, in participants of a 48-week randomized clinical trial of initial ART. Receiver operator characteristic curves examined diagnostic models of NCI. RESULTS: Cystatin C was associated with NCI before ART [odds ratio (OR) 3.4 (95% CI: 1.2 to 9.4) for each 2-fold increase in baseline levels] and during 48 weeks of ART, in models that excluded baseline measurements [OR 3.0 (1.2 to 7.8) for each 2-fold increase in time-updated levels]. The strength of association increased with more severe impairment using HIV-associated neurocognitive disorder criteria [OR 2.2 (0.8 to 6.0) with asymptomatic NCI and OR 4.0 (1.5 to 11.0) with mild neurocognitive disorder or HIV-associated dementia vs. no impairment, for each 2-fold increase in time-updated levels] or by global development score [OR 2.6 (1.1 to 6.3) with mild impairment and OR 4.6 (1.1 to 18.9) with moderate or severe impairment vs. no impairment]. Cystatin C performed poorly as a diagnostic marker for NCI, however, with an area under the receiver operator characteristic curve of 0.58 at baseline and 0.54 at week 48. CONCLUSIONS: Higher plasma cystatin C levels were significantly associated with NCI, but these levels did not seem to be useful as a diagnostic marker for this condition.
Authors: Robert C. Kalayjian, Kevin R. Robertson, Jeffrey M. Albert, Carl J. Fichtenbaum, Todd T. Brown, Babafemi O. Taiwo, for the ACTG 5303 Study Team
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
Awards: G1032411263, G1050281965, G1118287939, G119332616, G1214792496, NICHD INTERNATIONAL PEDIATRIC AND PERINATAL HIV STUDIES NETWORK COORDINATING CEN, G183157880, Vanderbilt HIV Clinical Trials Unit, G2127051194, G215709867, G2244966566, G2501702145, G2548217053, G2737559749, G374818150, G375632836, G3873853564, G390975780, North Carolina Translational & Clinical Sciences Institute (NC TraCS), G4099673573, G4553935269, G475936976, Case Clinical Trials Unit, G5046654427, Integrated University of Puerto Rico Clinical Trials Unit, The University of Rochester Clinical and Translational Science Institute, G5431849782, ADULT ACTG CENTRAL GROUP, G5469398932, Case AIDS Clinical Trials Unit, Institute for Clinical and Translational Research, G650174051, G6615853387, G661928818, G681742546, The University of Rochester's Clinical and Translational Science Institute, Partners Healthcare Systems/Harvard Medical School/Boston Medical Center AIDS CTU, G767300504, The Vanderbilt Institute for Clinical and Translational Research (VICTR), G857487509, Institute of Human Virology Clinical Trials Unit, G867868940, Clinical and Translational Science Collaborative of Cleveland, Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections, Rustbelt Center for AIDS Research (Case/UHC-Pitt CFAR), Center for AIDS Research at Emory University, Statistical and Data Management Center (SDMC), Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections (ACTG), The University of North Carolina Center for AIDS Research, Columbia Collaborative HIV/AIDS Clinical Trials Unit, University of North Carolina Global HIV Prevention and Treatment Clinical Trials Unit, G961682679, Colorado Clinical and Translational Science Institute (UL1)
OpenAlex ID: W2934532159