Higher Anti-Cytomegalovirus Immunoglobulin G Concentrations Are Associated With Worse Neurocognitive Performance During Suppressive Antiretroviral Therapy.

TitleHigher Anti-Cytomegalovirus Immunoglobulin G Concentrations Are Associated With Worse Neurocognitive Performance During Suppressive Antiretroviral Therapy.
Publication TypeJournal Article
Year of Publication2018
AuthorsLetendre, S, Bharti, AR, Perez-Valero, I, Hanson, B, Franklin, D, Woods, SPaul, Gianella, S, de Oliveira, MFaria, Heaton, RK, Grant, I, Landay, AL, Lurain, N
Corporate AuthorsCHARTER Group
JournalClin Infect Dis
Volume67
Issue5
Pagination770-777
Date Published2018 08 16
ISSN1537-6591
KeywordsAdult, Age Factors, Anti-HIV Agents, Antibodies, Viral, Antiretroviral Therapy, Highly Active, Biomarkers, CHARTER, Cohort Studies, Cross-Sectional Studies, Cytomegalovirus, Cytomegalovirus Infections, DNA, Viral, Female, HIV Infections, Humans, Immunoglobulin G, Internal, Male, Mental Status and Dementia Tests, neurocognitive disorders, Viral Load
Abstract

Background: Cytomegalovirus (CMV) has been linked to higher risk of cardiovascular disease and mortality. We aimed to determine if CMV is associated with neurocognitive performance in adults infected with human immunodeficiency virus (HIV).Methods: In this cross-sectional analysis, anti-CMV immunoglobulin G (IgG) concentrations in blood and CMV DNA copies in blood and cerebrospinal fluid (CSF) were measured in stored specimens of 80 HIV-infected adults who were previously assessed with a comprehensive neurocognitive test battery. Thirty-eight were taking suppressive antiretroviral therapy (ART) and 42 were not taking ART. A panel of 7 soluble biomarkers was measured by immunoassay in CSF.Results: Anti-CMV IgG concentrations ranged from 5.2 to 46.1 IU/mL. CMV DNA was detected in 7 (8.8%) plasma specimens but in no CSF specimens. Higher anti-CMV IgG levels were associated with older age (P = .0017), lower nadir CD4+ T-cell count (P < .001), AIDS (P < .001), and higher soluble CD163 (P = .009). Higher anti-CMV IgG levels trended toward an association with worse neurocognitive performance overall (P = .059). This correlation was only present in those taking suppressive ART (P = .0049). Worse neurocognitive performance remained associated with higher anti-CMV IgG levels after accounting for other covariates in multivariate models (model P = .0038). Detectable plasma CMV DNA was associated with AIDS (P = .05) but not with neurocognitive performance.Conclusions: CMV may influence neurocognitive performance in HIV-infected adults taking suppressive ART. Future clinical trials of anti-CMV therapy should help to determine whether the observed relationships are causal.

DOI10.1093/cid/ciy170
Alternate JournalClin. Infect. Dis.
PubMed ID29506084
PubMed Central IDPMC6093999
Grant ListU24 MH100928 / MH / NIMH NIH HHS / United States
R21 HD094646 / HD / NICHD NIH HHS / United States
R21 AI134295 / AI / NIAID NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
P30 AI036214 / AI / NIAID NIH HHS / United States
R01 MH107345 / MH / NIMH NIH HHS / United States
P01 AI131385 / AI / NIAID NIH HHS / United States
D43 TW000237 / TW / FIC NIH HHS / United States
HHSN271201000036C / MH / NIMH NIH HHS / United States
K24 MH097673 / MH / NIMH NIH HHS / United States