Increased Intrathecal Immune Activation in Virally Suppressed HIV-1 Infected Patients with Neurocognitive Impairment
Artikel i vetenskaplig tidskrift, 2016

Objective Although milder forms of HIV-associated neurocognitive disorder (HAND) remain prevalent, a correlation to neuronal injury has not been established in patients on antiretroviral therapy (ART). We examined the relationship between mild HAND and CSF neurofilament light protein (NFL), a biomarker of neuronal injury; and CSF neopterin, a biomarker of CNS immunoactivation, in virally suppressed patients on antiretroviral therapy (ART). We selected 99 subjects on suppressive ART followed longitudinally from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study. Based on standardized comprehensive neurocognitive performance (NP) testing, subjects were classified as neurocognitively normal (NCN; n = 29) or impaired (NCI; n = 70). The NCI group included subjects with asymptomatic (ANI; n = 37) or mild (MND; n = 33) HAND. CSF biomarkers were analyzed on two occasions. Geometric mean CSF neopterin was 25% higher in the NCI group (p = 0.04) and NFL and neopterin were significantly correlated within the NCI group (r = 0.30; p<0.001) but not in the NCN group (r = -0.13; p = 0.3). Additionally, a trend towards higher NFL was seen in the NCI group (p = 0.06). Mild HAND was associated with increased intrathecal immune activation, and the correlation between neopterin and NFL found in NCI subjects indicates an association between neurocognitive impairment, CNS inflammation and neuronal damage. Together these findings suggest that NCI despite ART may represent an active pathological process within the CNS that needs further characterization in prospective studies.

prevalence

deficit scores

csf

cerebrospinal-fluid neopterin

central-nervous-system

neurofilament protein

hiv-1 infection

antiretroviral

disorders

therapy

biomarkers

Författare

Arvid Edén

Göteborgs universitet

T. D. Marcotte

University of California

R. K. Heaton

University of California

Staffan Nilsson

Chalmers, Matematiska vetenskaper, matematisk statistik

Göteborgs universitet

Henrik Zetterberg

Göteborgs universitet

D. Fuchs

Medizinische Universitat Innsbruck

D. Franklin

University of California

R.W. Price

University of California

I. Grant

University of California

S. L. Letendre

University of California

Magnus Gisslén

Göteborgs universitet

PLoS ONE

1932-6203 (ISSN)

Vol. 11 0157160- e0157160

Ämneskategorier

Infektionsmedicin

DOI

10.1371/journal.pone.0157160

PubMed

27295036