Wednesday, May 29, 2019

Systemic and intrathecal immune activation in association with cerebral and cognitive outcomes in paediatric HIV

Children perinatally infected with human immunodeficiency virus (HIV) show poorer cognitive performance than uninfected peers, even with sustained virological suppression on combination antiretroviral therapy (cART). Widespread neuroimaging abnormalities, including decreased cerebral volume, decreased white matter (WM) integrity, altered neurometabolites, and regional perfusion changes suggest underlying cerebral injury1,2,3,4. While the underlying mechanisms of paediatric central nervous system (CNS) pathology in treated HIV infection remain unclear, increasing evidence suggests that HIV-associated immune and coagulation activation contribute to morbidity of multiple organ systems, including the CNS1,5.


We therefore aimed to characterize systemic and intrathecal markers of immune activation, endothelial function, and coagulation in a cohort of cART-treated perinatally HIV-infected children, and explore their relations to HIV-associated cognitive and cerebral deficits. First, we compared systemic biomarkers of immune activation, inflammation, endothelial function, and coagulation in HIV-infected children to those in matched uninfected controls. Then, we assessed whether systemic biomarker levels corresponded with intrathecal levels within the HIV-infected group. Lastly, we explored potential relationships between selected markers of immune activation, endothelial function, and previously detected cognitive deficits and magnetic resonance imaging (MRI) abnormalities.




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