title: Elevated sCD163 in plasma but not cerebrospinal fluid is a marker of neurocognitive impairment in HIV infection.
abstract: OBJECTIVE
  Here we evaluated whether neurocognitive disorders in HIV-infected individuals on effective antiretroviral therapy (ART) are associated with persistent monocyte activation as indexed by levels of soluble CD163 (sCD163), shed by monocyte/macrophages.
  
  
  METHODS
  Chronically, HIV-infected individuals were examined at two consecutive visits median [interquartile range (IQR)] 16 (7-32) months apart. All patients were on ART and durably virologically suppressed (plasma HIV RNA <50 copies/ml) at all visits. Thirty-four age-matched HIV-seronegative patients were used as controls.
  
  
  METHODS
  A global deficit score (GDS) was calculated based on comprehensive neuropsychological assessment according to standard methods. Neuropsychological and medical data were used to assign neurocognitive status according to published guidelines for HIV-associated neurocognitive disorders (HAND) as follows: neuropsychologically normal (NP-nml), asymptomatic neuropsychological impairment (ANI) and minor neurocognitive disorder (MND). sCD163 in plasma and cerebrospinal fluid was measured using ELISA.
  
  
  RESULTS
  GDS-impaired patients had higher plasma sCD163 than those who were not impaired [median (IQR) 1401 ng/ml (1057-2258) versus 955 ng/ml (586-1313); Wilcoxon P=0.028]. Patients with MND (N=6) had significantly higher plasma sCD163 than ANI (P=0.04) or NP-nml (P=0.02). Whereas plasma sCD163 levels dropped in patients who were stably GDS-unimpaired after the first visit (P<0.032), levels remained elevated in those who remained GDS-impaired (P=0.50).
  
  
  CONCLUSIONS
  These findings are consistent with persistent monocyte/macrophage activation in neurophysiologically impaired HIV-infected individuals despite virally suppressive ART. Overall, these observations underscore the significance of monocyte/macrophage immune responses in HIV, persistent monocyte activation in HAND and the value of sCD163, as a plasma marker of neurocognitive impairment.
authors: Department of Biology, Boston College, Chestnut Hill, Massachusetts 02467, USA.
authors: Tricia H
authors: TH
authors: Burdo
authors: Allison
authors: A
authors: Weiffenbach
authors: Steven P
authors: SP
authors: Woods
authors: Scott
authors: S
authors: Letendre
authors: Ronald J
authors: RJ
authors: Ellis
authors: Kenneth C
authors: KC
authors: Williams
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015703:Antigens, CD / Q000097:blood* / Q000134:cerebrospinal fluid; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood* / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000097:blood* / Q000134:cerebrospinal fluid; D016022:Case-Control Studies; D002555:Cerebrospinal Fluid / Q000276:immunology; D003072:Cognition Disorders / Q000097:blood* / Q000134:cerebrospinal fluid / Q000188:drug therapy; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000134:cerebrospinal fluid / Q000188:drug therapy; D018023:HIV Seronegativity / Q000276:immunology; D006679:HIV Seropositivity / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D008262:Macrophage Activation; D008264:Macrophages / Q000276:immunology*; D008297:Male; D009483:Neuropsychological Tests; D011956:Receptors, Cell Surface / Q000097:blood*; D000098902:CD163 Antigen
chemical_list: D044966:Anti-Retroviral Agents; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D000098902:CD163 Antigen; D011956:Receptors, Cell Surface