Variability in C-reactive protein is associated with cognitive impairment in women living with and without HIV: a longitudinal study

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作者
Leah H. Rubin
Lorie Benning
Sheila M. Keating
Philip J. Norris
Jane Burke-Miller
Antonia Savarese
Krithika N. Kumanan
Saria Awadalla
Gayle Springer
Kathyrn Anastos
Mary Young
Joel Milam
Victor G. Valcour
Kathleen M. Weber
Pauline M. Maki
机构
[1] University of Illinois at Chicago,Department of Psychiatry
[2] Johns Hopkins University School of Medicine,Department of Neurology
[3] Johns Hopkins University Bloomberg School of Public Health,Department of Epidemiology
[4] Blood Systems Research Institute,School of Public Health, Division of Epidemiology and Biostatistics
[5] Cook County Health and Hospitals System/Hektoen Institute of Medicine,Department of Medicine
[6] University of Illinois at Chicago,Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine
[7] Albert Einstein College of Medicine and Montefiore Medical Center,Memory and Aging Center, Department of Neurology
[8] Georgetown University,Department of Psychology
[9] University of Southern California,undefined
[10] University of California,undefined
[11] University of Illinois at Chicago,undefined
来源
Journal of NeuroVirology | 2018年 / 24卷
关键词
HIV; Cognition; Inflammation; Women; CRP;
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摘要
Despite the availability of effective antiretroviral therapies, cognitive impairment (CI) remains prevalent in HIV-infected (HIV+) individuals. Evidence from primarily cross-sectional studies, in predominantly male samples, implicates monocyte- and macrophage-driven inflammatory processes linked to HIV-associated CI. Thus, peripheral systemic inflammatory markers may be clinically useful biomarkers in tracking HIV-associated CI. Given sex differences in immune function, we focused here on whether mean and intra-individual variability in inflammatory marker-predicted CI in HIV+ and HIV− women. Seventy-two HIV+ (36 with CI) and 58 HIV− (29 with CI) propensity-matched women participating in the Women’s Interagency HIV Study completed a neuropsychological battery once between 2009 and 2011, and performance was used to determine CI status. Analysis of 13 peripheral immune markers was conducted on stored biospecimens at three time points (7 and 3.5 years before neuropsychological data collection and concurrent with data collection). HIV+ women showed alterations in 8 immune markers compared to HIV− women. The strongest predictors of CI across HIV+ and HIV− women were lower mean soluble tumor necrosis factor receptor I (sTNFRI) levels, higher mean interleukin (IL)-6 levels, and greater variability in C-reactive protein (CRP) and matrix metalloproteinase (MMP)-9 (p values < 0.05). Stratified by HIV, the only significant predictor of CI was greater variability in CRP for both HIV+ and HIV− women (p values < 0.05). This variability predicted lower executive function, attention/working memory, and psychomotor speed in HIV+ but only learning in HIV− women (p values < 0.05). Intra-individual variability in CRP levels over time may be a good predictor of CI in predominately minority low-socioeconomic status midlife women.
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页码:41 / 51
页数:10
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