|
|||||
|
|
Correlation between CD4/CD8 ratio and neurocognitive performance during early HIV infection |
|
| Authors: | Leah T. Le Richard W. Price Magnus Gisslén Henrik Zetterberg Brinda Emu Roxane Fabre Pradier Christian Signe Andersen Serena Spudich Matteo Vassallo |
| Affiliation: | 1. Department of Neurology, Yale School of Medicine, Yale University New Haven, New Haven, Connecticut, USA;2. Department of Neurology, University of California at San Francisco School of Medicine, San Francisco, California, USA;3. Department of Infectious Diseases at Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Region Västra Götaland, Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg, Sweden;4. Department of Psychiatry and Neurochemistry at Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK UK Dementia Research Institute at UCL, London, UK Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China;5. Department of Infectious Diseases and Pathology, Yale School of Medicine, Yale University New Haven, Connecticut, USA;6. Department of Public Health, Nice University Hospital, Université Côte d'Azur, Nice, France;7. Department of Infectious Diseases, Nice University Hospital, Université Côte d'Azur, Nice, France;8. Department of Neurology, Yale School of Medicine, Yale University New Haven, New Haven, Connecticut, USA Center foor Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA;9. Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France |
| Abstract: | IntroductionCD4/CD8 ratio is a marker of immune activation in HIV infection and has been associated with neurocognitive performance during chronic infection, but little is known about the early phases. The aim of this study was to examine the relationship between blood CD4/CD8 ratio and central nervous system endpoints in primary HIV infection (PHI) before and after antiretroviral treatment (ART).MethodsThis was a retrospective analysis of the Primary Infection Stage CNS Events Study (PISCES) cohort. We longitudinally assessed blood and cerebrospinal fluid (CSF) markers of inflammation, immune activation and neuronal injury, and neuropsychological testing performance (NPZ4, an average of three motor and one processing speed tests, and a summarized total score, NPZ11, including also executive function, learning and memory) in ART-naïve participants enrolled during PHI. Spearman correlation and linear mixed models assessed the relationships between the trajectory of CD4/CD8 ratio over time and neurocognitive performance, blood and CSF markers of immune activation and neuronal injury.ResultsIn all, 109 PHI participants were enrolled. The mean CD4/CD8 ratio decreased with longer time from infection to starting treatment (p < 0.001). Every unit increase in NPZ4 score was independently associated with a 0.15 increase in CD4/CD8 ratio (95% CI: 0.002–0.29; p = 0.047), whereas no correlation was found between CD4/CD8 ratio and NPZ11. Among the cognitive domains, only a change in processing speed was correlated with CD4/CD8 ratio over time (p = 0.03). The trajectory of the CD4/CD8 ratio was negatively correlated with change in CSF neurofilament light chain (p = 0.04).ConclusionsThe trajectory of CD4/CD8 ratio was independently associated with motor/psychomotor speed performance, suggesting that immune activation is involved in brain injury during the early stages of the infection. |
| Keywords: | CD4/CD8 ratio early HIV infection HIV-associated neurocognitive disorders immune activation |