| Publication Abstract Display | | Type: Poster | | Title: Plasma d-dimer relates to physical health and motor skills across the age span in HIV. | | Authors: Montoya J, Letendre S, Ellis R, Jeste D, Moore D | | Date: 03-04-2018 | | Abstract:Background: Inflammatory processes have been suggested as culprits for early neurologic abnormalities among persons living with HIV (PLWH), which have been purported to remit with effective antiretroviral treatment (ART). We hypothesized that inflammatory processes likely continue throughout the disease and may be associated with poorer physical health and worse fine motor skills as persons age with HIV.
Methods: The sample consisted of 107 PLWH and 95 HIV-uninfected adults, ages 36 to 65, with balanced recruiting in each age decade (36-45, 46-66, 56-65). Biomarkers of inflammation (d-dimer, IL-6, MCP-1, soluble CD14, and TNF- ) were measured. Participants completed the Medical Outcomes Study SF-36 to derive a physical health summary score, and fine motor skills were evaluated using the Grooved Pegboard Test. Standard statistical techniques were used for 1) group comparisons (i.e., Welch''s F Test or Wilcoxon rank sum test), 2) associations among continuous variables (i.e., Pearson''s or Spearman correlations), and 3) overall models (multivariable linear regressions to control for the effects of covariates that showed univariable association with outcome at <.10).
Results: Compared to the HIV-uninfected group, PLWH had higher levels of sCD14 (p=.03), MCP-1 (p<.001), and TNF- (p=.001) and reported poorer physical health (p<.001). Presence of HIV (p<.001) and older age decade (p<.001) were associated with poorer fine motor skills (i.e., lower scaled scores) (Model F=14.2, p<.001; figure). Among the biomarkers, only D-dimer ( =-.17, p=.01) and MCP-1 ( =-.24, p=.001) were associated with physical health. D-dimer (r=-.19, p=.01), IL-6 (r=-.15, p=.04), MCP-1 (r=-.16, p=.02), and TNF- (r=-.17, p=.01) had linear associations with fine motor skills, while sCD14 showed a quadratic association (p=.008), such that lower and higher values of sCD14 were associated with worse fine motor skills. Only d-dimer remained as a statistically significant predictor (p=.02) of fine motor skills in a multivariable model controlling for covariates.
Conclusions: Inflammatory processes may contribute to worse physical health, including worse fine motor skills throughout the course of HIV disease. Although neurologic findings (e.g., deficits in motor speed/dexterity) commonly associated with HIV infection have been suggested to largely remit with ART, our analysis indicates continued and worsening fine motor skills across the adult age continuum of PLWH beyond that expected from normal aging alone. |
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