Increased immune activation and signs of neuronal injury in HIV-negative people on preexposure prophylaxis
Artikel i vetenskaplig tidskrift, 2021

OBJECTIVE: Persistent immune activation in the central nervous system and systemically are common in people living with HIV (PLHIV) despite antiretroviral therapy. It is not known whether this is generated by HIV replication or by other components such as coinfections and lifestyle-related factors. DESIGN: The aim of this study was to determine the importance of different factors; it is crucial to find well matched HIV-negative controls. In this context, HIV-negative persons on preexposure prophylaxis (PrEP) may constitute a suitable control group to PLHIV with similar lifestyle-related factors. METHODS: Cerebrospinal fluid (CSF) and blood were collected from 40 HIV-negative persons on PrEP and 20 controls without PrEP. Biomarkers of immune activation, blood--brain barrier (BBB) integrity and neuronal injury were analysed. RESULTS: CSF and serum β2-microglobulin, serum neopterin and CSF neurofilament light protein were higher in persons on PrEP compared with controls. Furthermore, persons on PrEP had higher CSF/plasma albumin ratio, and matrix metalloproteinase-3 concentrations, indicating BBB dysfunction. Of persons on PrEP, 90% were cytomegalovirus (CMV)-positive compared to 65% of the controls. CMV-positive individuals as a group had higher levels of serum β2-microglobulin than CMV-negative individuals (P < 0.05). Drug users had higher serum β2-microglobulin compared to nonusers (P < 0.01). CONCLUSION: HIV-negative persons on PrEP had higher levels of biomarkers for immune activation, BBB impairment and neuronal injury, compared with volunteers without PrEP. Moreover, serum β2-microglobulin was higher in CMV-positive than in CMV-negative individuals and in drug users compared with nonusers. These findings are important to consider when analysing immune activation and CNS injury in PLHIV, and emphasize the importance of appropriate controls.

Författare

Josefina Robertson

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Arvid Edén

Sahlgrenska universitetssjukhuset

Göteborgs universitet

Kristina Nyström

Göteborgs universitet

L. Hagberg

Sahlgrenska universitetssjukhuset

Göteborgs universitet

Aylin Yilmaz

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Johanna M. Gostner

Medizinische Universität Innsbruck

D. Fuchs

Medizinische Universität Innsbruck

Staffan Nilsson

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Kaj Blennow

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Henrik Zetterberg

University College London (UCL)

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Magnus Gisslen

Sahlgrenska universitetssjukhuset

Göteborgs universitet

AIDS (London, England)

14735571 (eISSN)

Vol. 35 13 2129-2136

Ämneskategorier

Klinisk laboratoriemedicin

Biomedicinsk laboratorievetenskap/teknologi

Neurologi

DOI

10.1097/QAD.0000000000002980

PubMed

34115648

Mer information

Senast uppdaterat

2021-11-09