HIV陽性者および非陽性者における2年間の認知機能変化と血漿バイオマーカーとの関連
Jasmini Alagaratnam1,2, Nicholas Bakewell3, Ken M Kunisaki4
1Department of HIV Medicine & Sexual Health, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK.
Objective:
Chronic inflammation may be associated with cognitive disorders in people with HIV (PWH) on antiretroviral treatment (ART). We examine associations between cognitive function (CF) and plasma biomarkers measured in PWH and demographically-similar people without HIV in the POPPY study.
Design:
Prospective longitudinal cohort study.
Methods:
At baseline and 2-year follow-up, participants completed a cognitive test battery. Global T-scores were derived by averaging domain T-scores. We used linear regression to explore associations between changes in Global T-scores and log-transformed plasma biomarkers of neuronal injury, systemic inflammation and innate immune activation. We explored whether effects of biomarkers differed by HIV status.
Results:
349 participants were included (73% PWH, median [interquartile range, IQR] age 54 [50-60] years, 85% male, 95% white). Among PWH, 98% were on ART, 93% had HIV-RNA ≤ 50 copies/mL and median [IQR] CD4+ count was 627 [490,792] cells/mm3. Mean (standard deviation (SD)) baseline Global T-score was 47.7 (5.9) which increased to 48.9 (5.5) after a median [IQR] follow-up of 26 [24,29] months. Lower average increases in Global T-scores were seen in those with higher MIP-1α concentrations (parameter estimate: -0.27 [95%CI:-0.51,-0.03] /10% increase) and sCD14 (-0.17 [-0.30,-0.03]), though only MIP-1α (-0.46 [-0.58,-0.10]) remained significant after adjustment. There was no evidence that the associations differed by HIV status.
Conclusion:
Higher MIP-1α and sCD14 showed small associations with lower average increases in Global T-scores, with no differences by HIV status or inflammatory clusters, highlighting the multifactorial influences on cognitive trajectories in people ageing with and without HIV.
