CMV-infection has been associated with several inflammatory conditions and with increased monocyte/macrophage activation. HIV-associated neurocognitive dysfunction is an incompletely understood inflammatory condition. This study explores the potential role of CMV and monocyte/macrophage activation in neurocognitive dysfunction.
Utilizing stored serum specimens from 177 HIV+ and 183 HIV- subjects enrolled in the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA) cohort, quantitative CMV IgG, sCD14, and sCD163 were measured by ELISA. All subjects had previously undergone a battery of neurocognitive tests, including assessment of global cognition (GC) and 5 specific cognitive domains. Spearman correlations and linear regression analyses were used to assess for associations between neurocognitive performance, CMV IgG levels, and monocyte/macrophage activation as measured by sCD14 and sCD163.
The mean age was 58.7 (SD=6.2) years and mean education level was 13.4 (SD=2.0) years. Mean CD4 count was 621(SD=286) and 97% had undetectable HIV RNA. 166(94%) HIV+ and 135 (73%) HIV- subjects were CMV seropositive. Among all subjects, there was a significant positive correlation between CMV IgG and sCD14 (R=0.16, p=0.002) and CMV IgG and sCD163 (R=0.17, p=0.001). In linear regression models including age, sex, education, HIV status, CMV IgG, sCD163 and sCD14, the following were negatively associated with CMV IgG level: GC (β=-0.004, SE=0.001, p=0.003), episodic cognition (β=-0.005, SE=0.002, p=0.004), semantic memory (β=-0.004, SE=0.002, p=0.02), and visuospatial ability (β=-0.004, SE=0.002, p=0.05). The same models also showed that HIV positive participants had higher levels of GC, episodic memory, semantic memory, working memory, and visuospatial ability. There were no significant associations between sCD14 or SCD163 and cognitive function.
Among this cohort of older HIV+ and HIV- subjects, higher CMV IgG levels were associated with worse performance on several neurocognitive tests after controlling for age and education level. The potential mechanism of this association is unknown, but findings from this study suggest that it does not involve monocyte/macrophage activation.
S. Leurgans, None
L. Barnes, None
N. Lurain, None
O. Adeyemi, None