Limits...
Peripheral blood mononuclear cells HIV DNA levels impact intermittently on neurocognition.

Cysique LA, Hey-Cunningham WJ, Dermody N, Chan P, Brew BJ, Koelsch KK - PLoS ONE (2015)

Bottom Line: Low pre-morbid cognitive ability was uniquely associated with HAD (p<.05).Baseline HIV DNA was not associated with overall neurocognition.While the HIV DNA levels in PBMC are not associated with current non-demented HAND, increasing HIV DNA levels were associated with a decline in neurocognitive functions associated with HAND progression.

View Article: PubMed Central - PubMed

Affiliation: Neuroscience Research Australia, Sydney, Australia; Peter Duncan Neurosciences Unit, St. Vincent's Centre for Applied Medical Research, Sydney, Australia; The University of New South Wales (UNSW), Sydney, Australia.

ABSTRACT

Objectives: To determine the contribution of peripheral blood mononuclear cells' (PBMCs) HIV DNA levels to HIV-associated dementia (HAD) and non-demented HIV-associated neurocognitive disorders (HAND) in chronically HIV-infected adults with long-term viral suppression on combined antiretroviral treatment (cART).

Methods: Eighty adults with chronic HIV infection on cART (>97% with plasma and CSF HIV RNA <50 copies/mL) were enrolled into a prospective observational cohort and underwent assessments of neurocognition and pre-morbid cognitive ability at two visits 18 months apart. HIV DNA in PBMCs was measured by real-time PCR at the same time-points.

Results: At baseline, 46% had non-demented HAND; 7.5% had HAD. Neurocognitive decline occurred in 14% and was more likely in those with HAD (p<.03). Low pre-morbid cognitive ability was uniquely associated with HAD (p<.05). Log10 HIV DNA copies were stable between study visits (2.26 vs. 2.22 per 106 PBMC). Baseline HIV DNA levels were higher in those with lower pre-morbid cognitive ability (p<.04), and higher in those with no ART treatment during HIV infection 1st year (p = .03). Baseline HIV DNA was not associated with overall neurocognition. However, % ln HIV DNA change was associated with decline in semantic fluency in unadjusted and adjusted analyses (p = .01-.03), and motor-coordination (p = .02-.12) to a lesser extent.

Conclusions: PBMC HIV DNA plays a role in HAD pathogenesis, and this is moderated by pre-morbid cognitive ability in the context of long-term viral suppression. While the HIV DNA levels in PBMC are not associated with current non-demented HAND, increasing HIV DNA levels were associated with a decline in neurocognitive functions associated with HAND progression.

Show MeSH

Related in: MedlinePlus

% ln HIV DNA change and decline in Semantic Fluency.Red dashed line: 95% Confidence of interval, red line: Regression mean fit, blue dashed line: set at the mean of Y Leverage Residuals
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4390276&req=5

pone.0120488.g003: % ln HIV DNA change and decline in Semantic Fluency.Red dashed line: 95% Confidence of interval, red line: Regression mean fit, blue dashed line: set at the mean of Y Leverage Residuals

Mentions: Change in % ln HIV DNA levels between study time-points was associated with a decline in motor-coordination (Grooved Pegboard dominant hand) (r = -26, p<.03), and semantic fluency (animal category) (r = -25, p<.03). In multiple adjusted regression models, the % ln change in HIV DNA remained associated with declining motor coordination (ß = -.26, p<.02), and declining semantic fluency (ß = -.25; p = .02). In control analyses we excluded one HIV DNA change outlier, analyses remained significant for semantic fluency and trended for motor-coordination. Analyses are reported with and without the outlier as further inspection of this data point confirms that it was most likely a real datum (see Figs 2 and 3).


Peripheral blood mononuclear cells HIV DNA levels impact intermittently on neurocognition.

Cysique LA, Hey-Cunningham WJ, Dermody N, Chan P, Brew BJ, Koelsch KK - PLoS ONE (2015)

% ln HIV DNA change and decline in Semantic Fluency.Red dashed line: 95% Confidence of interval, red line: Regression mean fit, blue dashed line: set at the mean of Y Leverage Residuals
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4390276&req=5

pone.0120488.g003: % ln HIV DNA change and decline in Semantic Fluency.Red dashed line: 95% Confidence of interval, red line: Regression mean fit, blue dashed line: set at the mean of Y Leverage Residuals
Mentions: Change in % ln HIV DNA levels between study time-points was associated with a decline in motor-coordination (Grooved Pegboard dominant hand) (r = -26, p<.03), and semantic fluency (animal category) (r = -25, p<.03). In multiple adjusted regression models, the % ln change in HIV DNA remained associated with declining motor coordination (ß = -.26, p<.02), and declining semantic fluency (ß = -.25; p = .02). In control analyses we excluded one HIV DNA change outlier, analyses remained significant for semantic fluency and trended for motor-coordination. Analyses are reported with and without the outlier as further inspection of this data point confirms that it was most likely a real datum (see Figs 2 and 3).

Bottom Line: Low pre-morbid cognitive ability was uniquely associated with HAD (p<.05).Baseline HIV DNA was not associated with overall neurocognition.While the HIV DNA levels in PBMC are not associated with current non-demented HAND, increasing HIV DNA levels were associated with a decline in neurocognitive functions associated with HAND progression.

View Article: PubMed Central - PubMed

Affiliation: Neuroscience Research Australia, Sydney, Australia; Peter Duncan Neurosciences Unit, St. Vincent's Centre for Applied Medical Research, Sydney, Australia; The University of New South Wales (UNSW), Sydney, Australia.

ABSTRACT

Objectives: To determine the contribution of peripheral blood mononuclear cells' (PBMCs) HIV DNA levels to HIV-associated dementia (HAD) and non-demented HIV-associated neurocognitive disorders (HAND) in chronically HIV-infected adults with long-term viral suppression on combined antiretroviral treatment (cART).

Methods: Eighty adults with chronic HIV infection on cART (>97% with plasma and CSF HIV RNA <50 copies/mL) were enrolled into a prospective observational cohort and underwent assessments of neurocognition and pre-morbid cognitive ability at two visits 18 months apart. HIV DNA in PBMCs was measured by real-time PCR at the same time-points.

Results: At baseline, 46% had non-demented HAND; 7.5% had HAD. Neurocognitive decline occurred in 14% and was more likely in those with HAD (p<.03). Low pre-morbid cognitive ability was uniquely associated with HAD (p<.05). Log10 HIV DNA copies were stable between study visits (2.26 vs. 2.22 per 106 PBMC). Baseline HIV DNA levels were higher in those with lower pre-morbid cognitive ability (p<.04), and higher in those with no ART treatment during HIV infection 1st year (p = .03). Baseline HIV DNA was not associated with overall neurocognition. However, % ln HIV DNA change was associated with decline in semantic fluency in unadjusted and adjusted analyses (p = .01-.03), and motor-coordination (p = .02-.12) to a lesser extent.

Conclusions: PBMC HIV DNA plays a role in HAD pathogenesis, and this is moderated by pre-morbid cognitive ability in the context of long-term viral suppression. While the HIV DNA levels in PBMC are not associated with current non-demented HAND, increasing HIV DNA levels were associated with a decline in neurocognitive functions associated with HAND progression.

Show MeSH
Related in: MedlinePlus