Cognitive and Neuronal Link With Inflammation: A Longitudinal Study in People With and Without HIV Infection
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Across many settings, lack of virologic control remains common in people with HIV (PWH) because of late presentation and lack of retention in care. This contributes to neuronal damage and neurocognitive impairment, which remains prevalent. More evidence is needed to understand these outcomes in both PWH and people without HIV (PWOH). METHODS: We recruited PWH initiating antiretroviral therapy and PWOH at 2 sites in the United States. One hundred eight adults were enrolled (56 PWOH and 52 PWH), most of whom had a second assessment at least 24 weeks later (193 total assessments). Tumor necrosis factor alpha, monocyte chemotactic protein-1 (MCP-1), neopterin, soluble CD14, and neurofilament light chain protein (NFL) were measured in plasma and cerebrospinal fluid (CSF). Using multivariate models including Bayesian model averaging, we analyzed factors associated with global neuropsychological performance (NPT-9) and CSF NFL at baseline and over time. RESULTS: At baseline, higher CSF MCP-1 and plasma sCD14 were associated with worse NPT-9 in PWH, while CSF HIV RNA decrease was the only marker associated with improved NPT-9 over time. Among PWH, higher CSF neopterin was most closely associated with higher NFL. Among PWOH, higher CSF MCP-1 was most closely associated with higher NFL. After antiretroviral therapy initiation, decrease in CSF MCP-1 was most closely associated with NFL decrease. CONCLUSION: Monocyte-associated CSF biomarkers are highly associated with neuronal damage in both PWH and PWOH. More research is needed to evaluate whether therapies targeting monocyte-associated inflammation may ameliorate HIV-associated neurobehavioral diseases.
Institutions: Emory University, Indiana University Indianapolis, Indiana University School of Medicine, Innsbruck Medical University, Sahlgrenska University Hospital, Region Västra Götaland, University of Gothenburg, UK Dementia Research Institute, UCL Queen Square Institute of Neurology, University College London, University of California San Diego
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
Funders: Eli Lilly and Company, Biogen, Emory University, Torsten Söderbergs Stiftelse, Hjärnfonden, Knut och Alice Wallenbergs Stiftelse, Vetenskapsrådet, Göteborgs Universitet, National Institutes of Health, Center for AIDS Research, University of Washington, National Institute on Aging, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases
Awards: G183157880, HIV Neurocognitive Disorders: A Randomized Clinical Trial of CNS-Targeted HAART, G2385484910, G2675028044, The Alzheimer biomarker toolbox – use in pathogenic studies, diagnostics and theragnostics, G3027168043, G308275008, G313301595, G3350118538, G3715862790, G427239757, G453267231, Study of zidovudine addition in HIV-associated neurocognitive disorders, G4973408672, G6113675784, G791739130, Midcareer Investigator Award in Patient-Oriented NeuroAIDS Research, G8082634503, G9000033998, G9000061284, G9000102070, G9000195981, G9000258202, HIV Neurobehavioral Research Center
OpenAlex ID: W3087560759