Publication Abstract Display
Type: Published Manuscript
Title: Higher anti-CMV IgG concentrations are associated with worse neurocognitive performance during suppressive antiretroviral therapy.
Authors: Letendre S, Bharti A, Perez-Valero I, Hanson B, Franklin D, Woods SP, Gianella S, de Oliveira MF, Heaton RK, Grant I, Landay AL, Lurain N
Year: 2018
Publication: Clinical Infectious Diseases
Volume: 67 Issue: 5 Pages: 770-777
Abstract:Objective: To determine the association of CMV infection with neurocognitive performance in HIV+ adults. Design: Cross-sectional, observational, exploratory study. Methods: Anti-CMV IgG concentrations in blood and CMV DNA copies in blood and cerebrospinal fluid (CSF) were measured in stored specimens of 80 HIV+ adults who were previously assessed with a standardized, comprehensive neurocognitive test battery. Thirty-eight were taking suppressive antiretroviral therapy (ART, HIV RNA ≤ 50 copies/mL) and 42 were not taking ART. A panel of 7 soluble biomarkers were also measured by immunoassay in CSF. Results: Anti-CMV IgG concentrations ranged from 5.2 to 46.1 U/mL. CMV DNA was detected in 7 (8.8%) blood plasma but in none of the CSF specimens. Higher anti-CMV IgG levels were associated with older age (p=0.0017), lower nadir CD4+ T-cell count (p<0.001), AIDS (p<0.001), and higher soluble CD163 (p=0.009). Higher anti-CMV IgG levels trended toward an association with worse neurocognitive performance overall (p=0.059). This correlation was present in those taking suppressive ART (p=0.0049) but not in those who were not taking ART (p=0.92). Worse neurocognitive performance remained associated with higher anti-CMV IgG levels after accounting for other covariates in multivariate models (Model p=0.0038). Detectable plasma CMV DNA was associated with AIDS (p=0.05) but not with neurocognitive performance. Conclusion: CMV may influence neurocognitive performance in HIV+ adults taking suppressive ART. Future clinical trials of anti-CMV therapy should help determine whether the observed relationships are causal.

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