Publication Abstract Display
Type: Published Manuscript
Title: Plasma SCD14 is a biomarker associated with impaired neurocognitive test performance in attention and learning domains in HIV infection.
Authors: Lyons JL, Uno H, Ancuta P, Kamat A, Moore DJ, Singer EJ, Morgello S, Gabuzda D
Year: 2011
Publication: Journal of Acquired Immune Deficiency Syndromes (1999)
Volume: 57 Issue: 5 Pages: 371-379
Abstract:OBJECTIVE:: Mild forms of HIV-associated neurocognitive disorders (HAND) remain prevalent in the era of combination antiretroviral therapy (cART). Although elevated LPS and immune activation are implicated in HAND pathogenesis, relationships of LPS and inflammatory markers to mild forms of HAND or impairment in specific cognitive domains are unknown. To examine these relationships, we compared plasma soluble CD14 (sCD14), CCL2, and LPS levels to neurocognitive test scores in a cART era cohort. METHODS:: We analyzed plasma from HIV+ subjects (n=97) with nadir CD4 counts <300 and high frequency of HCV co-infection and illicit drug use for relationships between sCD14, CCL2, and LPS levels and neurocognitive test scores. RESULTS:: Plasma sCD14 levels were higher in subjects with test scores indicating global impairment (p=0.007), particularly in attention and learning domains (p=0.015 and p=0.03, respectively), regardless of HAND diagnosis. Plasma sCD14 levels correlated inversely with global, attention, and learning T scores (p=0.036, 0.047, and 0.007, respectively), and yielded higher AUROC values for predicting impaired scores than single-marker models based on plasma or CSF viral load or CD4 count (AUROC 0.71, 0.81, and 0.71, respectively), and in four-marker models based on plasma sCD14 and three conventional markers compared to the three-marker models. CONCLUSIONS:: Plasma sCD14 is a biomarker associated with impaired neurocognitive testing in attention and learning domains in HIV-infected individuals with advanced disease, suggesting involvement of cortical and limbic pathways by inflammatory processes in the cART era. Plasma sCD14 is a potential biomarker to monitor HAND progression and therapeutic responses.

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