Publication Abstract Display
Type: Published Manuscript
Title: Elevated SCD163 in plasma but not csf is a marker of neurocognitive impairment in HIV infection.
Authors: Burdo TH, Weiffenbach A, Woods SP, Letendre S, Ellis RJ, Williams KC
Year: 2013
Publication: AIDS (London, England)
Volume: 27 Issue: 9 Pages: 1387-1395
Abstract:OBJECTIVE: Here we evaluated whether neurocognitive disorders in HIV-infected individuals on effective antiretroviral therapy (ART) are associated with persistent monocyte activation as indexed by levels of soluble CD163 (sCD163), shed by monocyte/macrophages. DESIGN: Chronically HIV-infected individuals were examined at two consecutive visits median (IQR) 16 (7, 32) months apart. All subjects were on ART and durably virologically suppressed (plasma HIV RNA < 50c/mL) at all visits. 34 age-matched HIV-seronegative subjects were used as controls. METHODS: A global deficit score (GDS) was calculated based on comprehensive neuropsychological (NP) according to standard methods. NP and medical data were used to assign neurocognitive status according to published guidelines for HIV-associated neurocognitive disorders (HAND) as follows: neuropsychologically normal (NP-nml), asymptomatic neuropsychological impairment (ANI) and minor neurocognitive disorder (MND). sCD163 in plasma and CSF was measured using ELISA. RESULTS: GDS-impaired subjects had higher plasma sCD163 than those who were not impaired (median [IQR] 1401 ng/mL [1057, 2258] versus 955 ng/mL [586,1313]; Wilcoxon p = 0.028). Subjects with MND (N = 6) had significantly higher plasma sCD163 than ANI (p = 0.04) or NP-nml (p = 0.02). Whereas plasma sCD163 levels dropped in subjects who were stably GDS-unimpaired after the first visit (p < 0.032), levels remained elevated in those who remained GDS-impaired (p = 0.50).Interpretation: These findings are consistent with persistent monocyte/macrophage activation in NP-impaired HIV-infected individuals despite virally suppressive ART. Overall, these observations underscore the significance of monocyte/macrophage immune responses in HIV, persistent monocyte activation in HAND and the value of sCD163, as a plasma marker of neurocognitive impairment.

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