Neurocognitive Dysfunction in HIV-Infected Youth: Investigating the Relationship with Immune Activation
Autor: | Julia C. Rosebush, Mary Ann O'Riordan, Anita K. Grover, Ann Chahroudi, Allison Ross Eckard, Joshua H. Ruff, Jakob Habib, Chanda C. Graves, Ashley Alexander, Grace A. McComsey, S. Thera Lee |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male Cart Adolescent Cross-sectional study Population Neurocognitive Disorders HIV Infections Lymphocyte Activation Article Immunophenotyping Young Adult 03 medical and health sciences 0302 clinical medicine Immunity Antiretroviral Therapy Highly Active Humans Medicine Cognitive Dysfunction Pharmacology (medical) 030212 general & internal medicine Young adult Child education Pharmacology education.field_of_study business.industry HIV Viral Load Mental Status and Dementia Tests Antiretroviral therapy CD4 Lymphocyte Count Cross-Sectional Studies Treatment Outcome Infectious Diseases Immunology Female business Viral load Neurocognitive Biomarkers 030217 neurology & neurosurgery |
Zdroj: | Antiviral Therapy. 22:669-680 |
ISSN: | 2040-2058 1359-6535 |
DOI: | 10.3851/imp3157 |
Popis: | Background HIV-infected individuals are at increased risk of neurocognitive impairment compared to the general population. Studies suggest that, despite combination antiretroviral therapy (cART), HIV infection causes immune activation which results in neural damage; however, few data exist in HIV-infected youth. Methods HIV-infected youth 8–26-years-old on cART with virological suppression were prospectively enrolled along with healthy controls. Neurocognitive performance was assessed by age-appropriate Wechsler Intelligence Scales. Soluble and cellular markers of T-lymphocyte and monocyte activation were measured by ELISA and flow cytometry, respectively. Results 45 HIV-infected subjects and 21 controls were enrolled. Markers of T-cell and monocyte activation were higher in the HIV-infected subjects compared to controls, but proportions of inflammatory and patrolling monocytes were similar. Although there were no significant differences in neurocognitive scores between the HIV-infected and control groups, scores were low-average for four of five testing domains for the HIV-infected subjects and average for all five in the controls, and % of HIV-infected subjects with scores classified as ‘low average’ or below was higher than in the controls. Variables most associated with neurocognitive performance among HIV-infected subjects included activated CD4+ T-cells (% CD4+CD38+HLA-DR), monocyte activation (soluble CD14), HIV duration, age and sex. Conclusions HIV-infected youth on cART with virological suppression show subtle evidence of neurocognitive impairment compared to healthy controls, and increased immune activation appears to play a role. Additional studies are needed to develop strategic interventions beyond cART to potentially improve neurocognitive performance and/or minimize further impairment in this vulnerable population. ClinicalTrials.gov Identifier: NCT01523496. |
Databáze: | OpenAIRE |
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