469. Neurocognitive Dysfunction in HIV-Infected Youth: Investigating the Relationship to Immune Activation
Session: Poster Abstract Session: Pediatric HIV
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • NC_IDWeek_poster2015.pdf (1.6 MB)
  • Background: HIV+ individuals are at increased risk of developing neurocognitive impairment compared to the general population. It is postulated that ongoing viral replication causes immune activation that results in neural damage; however, few studies have investigated this phenomenon in the pediatric and young adult HIV-infected population.

    Methods: This was an exploratory, cross-sectional study evaluating the association of neurocognitive impairment in virologically-suppressed HIV-1-infected youth ages 8-26 years old with immune activation compared to matched healthy controls. Neurocognitive performance was assessed by age-appropriate Wechsler intelligence scales and markers of lymphocyte and monocyte immune activation by ELISA and flow cytometry in plasma and PBMC samples. Analyses used non-parametric tests, Spearman coefficients, and multivariable linear regression.

    Results: 68 subjects (47 HIV+: 57% male, 89% black, mean age 19 years) were enrolled. Mean scores were low-average for 4 of 5 testing domains for the HIV+ subjects and average for all 5 in the controls. Working memory was statistically lower in the HIV+ group compared to the controls (89 vs. 99; P=0.04). Markers of CD4+ and CD8+ T-cell activation and monocyte activation were higher in the HIV+ subjects compared to the controls, but proportions of inflammatory (CD14+CD16+) and patrolling monocytes (CD14dimCD16+) were similar between groups. In the HIV+ group, plasma levels of soluble CD14 and %CD4+CD38+HLA-DR+ activated T-lymphocytes were negatively correlated with verbal comprehension, and HIV duration was negatively associated with verbal comprehension, working memory and full-scale intelligence quotient. Marijuana use was positively associated with working memory and processing speed. In multivariable regression evaluating associations with working memory, HIV duration was the only statistically significant factor (P = 0.038).

    Conclusion: HIV-infected youth have evidence of neurocognitive impairment and increased immune activation compared to matched healthy controls. While there may be a relationship between neurocognitive impairment and immune activation in HIV+ youth as evidenced by significant univariate relationships, HIV duration appears to be the most important factor in this study.

    Julia Rosebush, DO1, Ann Chahroudi, MD, PhD1, Seungeun Lee, BS1, Mary Ann O'Riordan, MS, PhD2,3, Chanda Graves, PhD1, Anita Grover, PsyD4, Ashley Alexander, PsyD5, Bridget Wynn, BS1, Grace McComsey, MD2,3 and Allison R. Eckard, MD1, (1)Emory University School of Medicine, Atlanta, GA, (2)Case Western Reserve University School of Medicine, Cleveland, OH, (3)Rainbow Babies and Children's Hospital, Cleveland, OH, (4)Georgia State University, Atlanta, GA, (5)Children's Healthcare of Atlanta, Atlanta, GA

    Disclosures:

    J. Rosebush, None

    A. Chahroudi, None

    S. Lee, None

    M. A. O'Riordan, None

    C. Graves, None

    A. Grover, None

    A. Alexander, None

    B. Wynn, None

    G. McComsey, Bristol Myers-Squibb: Consultant , Investigator and Speaker's Bureau , Consulting fee , Grant recipient , Research grant and Speaker honorarium
    ViiV/GSK: Consultant , Investigator and Speaker's Bureau , Consulting fee , Grant recipient , Research grant and Speaker honorarium
    Gilead: Consultant , Investigator and Speaker's Bureau , Consulting fee , Grant recipient , Research grant and Speaker honorarium
    ICON: Consultant , Investigator and Speaker's Bureau , Consulting fee , Grant recipient , Research grant and Speaker honorarium
    Merck: Consultant , Investigator and Speaker's Bureau , Consulting fee , Grant recipient , Research grant and Speaker honorarium

    A. R. Eckard, Bristol Myers-Squibb: Investigator , Grant recipient and Research grant
    Cubist Pharmaceuticals: Investigator , Grant recipient and Research grant
    GSK: Investigator , Grant recipient and Research grant
    Gilead: Scientific Advisor , honorarium

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