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Increased Peripheral Inflammation Is Associated With Structural Brain Changes and Reduced Blood Flow in People With

Tricia H Burdo1, Jake A Robinson1, Sarah Cooley2

  • 1Department of Microbiology, Immunology, and Inflammation, Center for Neurovirology and Gene Editing, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.

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Chronic immune activation in people with HIV (PWH) on antiretroviral therapy (ART) is linked to brain volume loss. Elevated soluble CD14 is associated with reduced cerebral blood flow, indicating ongoing neurological impact.

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HIVbraininflammationneuroimaging

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Area of Science:

  • Neuroscience
  • Immunology
  • Infectious Diseases

Background:

  • Antiretroviral therapy (ART) improves outcomes for people with HIV (PWH), but brain dysfunction persists.
  • Elevated immune activation and inflammation in PWH on ART contribute to disease.
  • Mechanisms underlying cognitive and structural brain changes in PWH remain unclear.

Purpose of the Study:

  • To investigate the relationship between immune markers and neuroimaging findings in PWH with viral suppression on ART.
  • To explore associations between immune cell counts, plasma inflammatory markers, and brain structure/function.

Main Methods:

  • A cohort of 173 PWH with ART adherence and viral suppression was studied.
  • Measurements included CD4/CD8 T-cell ratio, CD16+ monocytes, plasma soluble CD163 and CD14.
  • Neuroimaging assessed brain volume and cerebral blood flow (CBF).

Main Results:

  • Lower CD4/CD8 T-cell ratios correlated with reduced brain volume.
  • Higher CD16+ monocyte counts were associated with decreased gray matter and total cortex volume.
  • Increased plasma soluble CD14 was linked to reduced CBF in multiple cortical regions and total gray matter.

Conclusions:

  • Chronic immune markers like CD4/CD8 ratio and CD16+ monocytes are associated with brain volume loss in PWH.
  • Plasma soluble CD14 may represent a novel biomarker for reduced cerebral blood flow in this population.