| Publication Abstract Display | | Type: Poster | | Title: Profiles and predictors of HIV-associated neurocognitive impairment in the context of low and high blood-brain barrier (BBB) permeability. | | Authors: Iudicello J, Gongvatana A, Franklin D, Rosario D, Ellis R, Grant I, Heaton R, Letendre S | | Date: 02-01-2017 | | Abstract:Conlcusions:
BBB permeability, which varies by age, gender, ethnicity, and aging- related conditions and risk factors, may play an important role in the persistence of adverse CNS outcomes in HIV, such as neurocognitive impairment (NCI)
Consistent with prior research, we found a significant association between higher BBB permeability (i.e., higher CSARs) and NCI9 in our treated HIV+ sample. While preliminary, our findings suggest that low BBB permeability may also be a risk factor for NCI in HIV+ individuals
We also found evidence to suggest that the underlying etiologies and profiles of NCI may differ in the context of low vs high BBB permeability
NCI in the context of high BBB permeability may be more closely linked to ARV-related (e.g., neurotoxicity) as well as vascular and/or metabolic risk factors (e.g., high blood pressure, high lipid levels)
NCI in the context of low BBB permeability may be related to factors such as poor penetration and/or ineffectiveness of ART, and comorbid conditions (e.g., co-infection with HCV, Diabetes)
Vascular risk factors and associated pathology may play a prominent role in NCI in treated HIV+ individuals, and individuals with high BBB permeability may be particularly vulnerable to these effects
The high BBB permeability group was more likely to be impaired in domains sensitive to vascular disease and underlying frontal- subcortical regions (e.g., speeded information processing, motor)10,11.
Overall, these findings provide support for the utility of BBB biomarkers (e.g., CSAR) in the early identification and prevention of neurological and neurocognitive impairment, and insight into the variability in patients’ response to ART and guidance for the development of individualized treatment regimens that may more effectively improve disease outcomes. |
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