title: Cerebrospinal fluid and neuroimaging biomarker abnormalities suggest early neurological injury in a subset of individuals during primary HIV infection.
abstract: BACKGROUND
  Cerebrospinal fluid (CSF) and neuroimaging abnormalities demonstrate neuronal injury during chronic AIDS, but data on these biomarkers during primary human immunodeficiency virus (HIV) infection is limited.
  
  
  METHODS
  We compared CSF concentrations of neurofilament light chain, t-tau, p-tau, amyloid precursor proteins, and amyloid-beta 42 in 92 subjects with primary HIV infection and 25 controls. We examined relationships with disease progression and neuroinflammation, neuropsychological testing, and proton-magnetic resonance spectroscopy (MRS)-based metabolites.
  
  
  RESULTS
  Neurofilament light chain was elevated in primary HIV infection compared with controls (P = .0004) and correlated with CSF neopterin (r = 0.38; P = .0005), interferon gamma-induced protein 10 (r = 0.39; P = .002), white blood cells (r = 0.32; P = .004), protein (r = 0.59; P < .0001), and CSF/plasma albumin ratio (r = 0.60; P < .0001). Neurofilament light chain correlated with decreased N-acteylaspartate/creatine and glutamate/creatine in the anterior cingulate (r = -0.35, P = .02; r = -0.40, P = .009, respectively), frontal white matter (r = -0.43, P = .003; r = -0.30, P = .048, respectively), and parietal gray matter (r = -0.43, P = .003; r = -0.47, P = .001, respectively). Beta-amyloid was elevated in the primary infection group (P = .0005) and correlated with time infected (r = 0.34; P = .003). Neither marker correlated with neuropsychological abnormalities. T-tau and soluble amyloid precursor proteins did not differ between groups.
  
  
  CONCLUSIONS
  Elevated neurofilament light chain and its correlation with MRS-based metabolites suggest early neuronal injury in a subset of participants with primary HIV infection through mechanisms involving central nervous system inflammation.
authors: Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
authors: Michael J
authors: MJ
authors: Peluso
authors: Dieter J
authors: DJ
authors: Meyerhoff
authors: Richard W
authors: RW
authors: Price
authors: Julia
authors: J
authors: Peterson
authors: Evelyn
authors: E
authors: Lee
authors: Andrew C
authors: AC
authors: Young
authors: Rudy
authors: R
authors: Walter
authors: Dietmar
authors: D
authors: Fuchs
authors: Bruce J
authors: BJ
authors: Brew
authors: Paola
authors: P
authors: Cinque
authors: Kevin
authors: K
authors: Robertson
authors: Lars
authors: L
authors: Hagberg
authors: Henrik
authors: H
authors: Zetterberg
authors: Magnus
authors: M
authors: Gisslén
authors: Serena
authors: S
authors: Spudich
mesh_terms: D000328:Adult; D015415:Biomarkers; D002555:Cerebrospinal Fluid / Q000737:chemistry*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology*; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid; D059906:Neuroimaging / Q000379:methods*
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins