title: Associations between Cognition, Gender and Monocyte Activation among HIV Infected Individuals in Nigeria.
abstract: The potential role of gender in the occurrence of HIV-related neurocognitive impairment (NCI) and associations with markers of HIV-related immune activity has not been previously examined. In this study 149 antiretroviral-naïve seropositive subjects in Nigeria (SP, 92 women and 57 men) and 58 seronegative (SN, 38 women and 20 men) were administered neuropsychological testing that assessed 7 ability domains. From the neuropsychological test scores was calculated a global deficit score (GDS), a measure of overall NCI. Percentages of circulating monocytes and plasma HIV RNA, soluble CD163 and soluble CD14 levels were also assessed. HIV SP women were found to be younger, more educated and had higher CD4+ T cell counts and borderline higher viral load measures than SP men. On the neuropsychological testing, SP women were more impaired in speed of information processing and verbal fluency and had a higher mean GDS than SN women. Compared to SP men, SP women were also more impaired in speed of information processing and verbal fluency as well as on tests of learning and memory. Numbers of circulating monocytes and plasma sCD14 and sCD163 levels were significantly higher for all SP versus all SN individuals and were also higher for SP women and for SP men versus their SN counterparts. Among SP women, soluble CD14 levels were slightly higher than for SP men, and SP women had higher viral load measurements and were more likely to have detectable virus than SP men. Higher sCD14 levels among SP women correlated with more severe global impairment, and higher viral load measurements correlated with higher monocyte numbers and sCD14 and sCD14 levels, associations that were not observed for SP men. These studies suggest that the risk of developing NCI differ for HIV infected women and men in Nigeria and, for women, may be linked to effects from higher plasma levels of HIV driving activation of circulating monocytes.
authors.affiliation: Department of Neurology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Walter
authors.initials: W
authors.lastname: Royal
authors.affiliation: HIV Neurobehavioral Research Center, University of California San Diego, School of Medicine, San Diego, California, United States of America.
authors.forename: Mariana
authors.initials: M
authors.lastname: Cherner
authors.affiliation: Department of Biology, Boston College, Chestnut Hill, Massachusetts, United States of America.
authors.forename: Tricia H
authors.initials: TH
authors.lastname: Burdo
authors.affiliation: HIV Neurobehavioral Research Center, University of California San Diego, School of Medicine, San Diego, California, United States of America.
authors.forename: Anya
authors.initials: A
authors.lastname: Umlauf
authors.affiliation: Department of Biology, Boston College, Chestnut Hill, Massachusetts, United States of America.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.affiliation: Institute for Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.|Institute for Human Virology-Nigeria, Abuja, Nigeria.
authors.forename: Jibreel
authors.initials: J
authors.lastname: Jumare
authors.affiliation: Institute for Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.|Institute for Human Virology-Nigeria, Abuja, Nigeria.
authors.forename: Alash'le
authors.initials: A
authors.lastname: Abimiku
authors.affiliation: University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
authors.forename: Peter
authors.initials: P
authors.lastname: Alabi
authors.affiliation: Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.
authors.forename: Nura
authors.initials: N
authors.lastname: Alkali
authors.affiliation: National Hospital, Abuja, Nigeria.
authors.forename: Sunday
authors.initials: S
authors.lastname: Bwala
authors.affiliation: Institute for Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.|Institute for Human Virology-Nigeria, Abuja, Nigeria.
authors.forename: Kanayo
authors.initials: K
authors.lastname: Okwuasaba
authors.affiliation: Institute for Human Virology-Nigeria, Abuja, Nigeria.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Eyzaguirre
authors.affiliation: Institute for Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.|Institute for Human Virology-Nigeria, Abuja, Nigeria.
authors.forename: Christopher
authors.initials: C
authors.lastname: Akolo
authors.affiliation: Department of Neurology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Ming
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Biology, Boston College, Chestnut Hill, Massachusetts, United States of America.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Williams
authors.affiliation: Institute for Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: William A
authors.initials: WA
authors.lastname: Blattner
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015703:Antigens, CD / Q000378:metabolism; D003071:Cognition; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology*; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D009000:Monocytes / Q000473:pathology*; D009483:Neuropsychological Tests; D009549:Nigeria / Q000453:epidemiology; D012727:Sex Characteristics
chemical_list: D015703:Antigens, CD
references.citation: J Infect Dis. 2007 Jul 1;196(1):38-42
references.pmid: 17538881
references.citation: J Natl Med Assoc. 2006 Aug;98(8):1260-2
references.pmid: 16916122
references.citation: PLoS One. 2008;3(6):e2516
references.pmid: 18575590
references.citation: Am J Epidemiol. 2008 Sep 1;168(5):532-40
references.pmid: 18663213
references.citation: J Leukoc Biol. 2008 Nov;84(5):1271-8
references.pmid: 18664531
references.citation: Nat Rev Immunol. 2008 Sep;8(9):737-44
references.pmid: 18728636
references.citation: J Leukoc Biol. 2010 Dec;88(6):1201-5
references.pmid: 20807704
references.citation: Neurology. 2010 Dec 7;75(23):2087-96
references.pmid: 21135382
references.citation: J Neurovirol. 2011 Feb;17(1):3-16
references.pmid: 21174240
references.citation: J Infect Dis. 2011 Mar 15;203(6):780-90
references.pmid: 21252259
references.citation: J Infect Dis. 2011 Jul 1;204(1):154-63
references.pmid: 21628670
references.citation: J Acquir Immune Defic Syndr. 2011 Aug 15;57(5):371-9
references.pmid: 21646912
references.citation: J Infect Dis. 2011 Oct 15;204(8):1227-36
references.pmid: 21917896
references.citation: J Nerv Ment Dis. 2012 Apr;200(4):336-42
references.pmid: 22456588
references.citation: J Neurovirol. 2012 Jun;18(3):191-9
references.pmid: 22528480
references.citation: Nature. 2001 Jan 11;409(6817):198-201
references.pmid: 11196644
references.citation: J Clin Exp Neuropsychol. 2001 Apr;23(2):149-63
references.pmid: 11309669
references.citation: J Infect Dis. 2001 Sep 15;184(6):699-706
references.pmid: 11517430
references.citation: Biochem Biophys Res Commun. 2001 Nov 9;288(4):841-3
references.pmid: 11688984
references.citation: J Neurovirol. 2001 Dec;7(6):528-41
references.pmid: 11704885
references.citation: Blood. 2002 Jan 1;99(1):378-80
references.pmid: 11756196
references.citation: J Leukoc Biol. 2002 Oct;72(4):711-7
references.pmid: 12377940
references.citation: J Acquir Immune Defic Syndr. 2002 Oct 1;31 Suppl 2:S43-54
references.pmid: 12394782
references.citation: AIDS. 2004 Jan 1;18 Suppl 1:S27-34
references.pmid: 15075495
references.citation: J Acquir Immune Defic Syndr. 2004 Jul 1;36(3):817-22
references.pmid: 15213565
references.citation: J Clin Exp Neuropsychol. 2004 May;26(3):307-19
references.pmid: 15512922
references.citation: Annu Rev Immunol. 1990;8:169-94
references.pmid: 2188662
references.citation: J Clin Pathol. 1991 Nov;44(11):936-45
references.pmid: 1721628
references.citation: Arch Neurol. 1995 Dec;52(12):1174-82
references.pmid: 7492292
references.citation: Arterioscler Thromb Vasc Biol. 1996 Feb;16(2):256-61
references.pmid: 8620340
references.citation: AIDS. 1996 Apr;10(4):431-40
references.pmid: 8728048
references.citation: J Neurovirol. 1996 Dec;2(6):404-10
references.pmid: 8972422
references.citation: Lancet. 1997 Mar 8;349(9053):692-5
references.pmid: 9078201
references.citation: Arch Neurol. 1997 Apr;54(4):416-24
references.pmid: 9109743
references.citation: J Int Neuropsychol Soc. 1998 Mar;4(2):172-8
references.pmid: 9529827
references.citation: Blood. 1998 Sep 15;92(6):2084-92
references.pmid: 9731066
references.citation: Nat Med. 2006 Dec;12(12):1365-71
references.pmid: 17115046
references.citation: AIDS. 2013 Jun 1;27(9):1387-95
references.pmid: 23435298
references.citation: J Infect Dis. 2013 Dec 1;208(11):1737-46
references.pmid: 24041790
references.citation: J Biomed Opt. 2013 Nov;18(11):110501
references.pmid: 24193944
references.citation: J Infect Dis. 2014 Feb 15;209(4):500-9
references.pmid: 24041796
references.citation: Respir Physiol. 1998 Dec;114(3):269-75
references.pmid: 9926990
references.citation: Lancet. 1998 Nov 7;352(9139):1510-4
references.pmid: 9820299
references.citation: J Neurovirol. 2014 Aug;20(4):380-7
references.pmid: 24927825
references.citation: Eur J Neurol. 1999 Mar;6(2):205-9
references.pmid: 10053233
references.citation: Am J Pathol. 2006 Mar;168(3):822-34
references.pmid: 16507898
references.citation: J Leukoc Biol. 2006 Jul;80(1):26-35
references.pmid: 16799153
references.citation: J Neurol Sci. 2008 Apr 15;267(1-2):142-6
references.pmid: 18001772