Cerebrospinal fluid biomarkers of inflammation and immune activation associated with neurocognitive impairment among US Latinos with HIV.

OBJECTIVE: Examine the association between markers of inflammation in the cerebrospinal fluid (CSF) and neurocognitive impairment (NCI) among diverse persons with HIV (PWH). BACKGROUND: Latino PWH are at higher risk for NCI than non-Latino White PWH (NLW). Evidence of inflammation in CSF can be higher among racial and ethnic minority PWH and has been linked to NCI. METHODS: We performed a retrospective cross-sectional analysis of 363 PWH who identified as Latinos or NLW. Neurocognitive performance was measured by a comprehensive battery. A focused panel of biomarkers [interleukin-6 (IL-6), soluble CD14 (sCD14), interferon-γ-inducible protein-10 (IP-10), neurofilament light chain (NFL)] was measured in CSF by immunoassay. Covariates included demographic, HIV disease, medical, psychiatric, and substance use characteristics. RESULTS: The cohort consisted of 126 Latinos and 237 NLW (age: M  = 42.5, SD  = 11.0, 88% male, 51.5% AIDS history; 64% on antiretroviral therapy). Latinos had significantly higher NFL levels than NLW ( P  < 0.0001, adjusted Cohen's d 1.15), but not among virally-suppressed PWH. In the entire cohort, higher sCD14 was associated with NCI (adjusted odds ratio (aOR) = 2.6, confidence interval (CI) = 1.1-6.5] after adjusting for statistically significant covariates. CONCLUSIONS: We did not identify a relationship between ethnicity, inflammation and NCI in this cohort. Future studies might examine sociocultural factors leading to increased inflammation in the CSF in diverse PWH.

Duke Scholars

Author Maria J. Marquine Medicine, Geriatrics and Palliative Care