Publication Abstract Display
Type: Published Manuscript
Title: Higher Cystatin C levels are associated with neurocognitive impairment in older HIV+ adults.
Authors: Sakoda ME, Fazeli PL, Ellis RJ, Jeste DV, Grant I, Letendre SL, Moore DJ
Year: 2017
Publication: Journal of Acquired Immune Deficiency Syndromes (1999)
Volume: 74 Issue: 3 Pages: 243-249
Abstract:OBJECTIVE: The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI). METHODS: Participants included 124 (HIV+ n = 77; HIV- n = 47) older adults (age ≥ 50 years) examined at the UCSD HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI. RESULTS: The HIV+ group had significantly higher cystatin C concentrations than the HIV- group (d=0.79 p<0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d=0.42, p=0.055), particularly among participants taking tenofovir (d=0.78, p=0.004). A receiver-operator characteristic curve identified that cystatin C levels ≥ 0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; p = 0.03). CONCLUSIONS: Our results confirm that HIV+ older adults have higher cystatin C than HIV- older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.

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