title: Short Communication: Do Cytomegalovirus Antibody Levels Associate with Age-Related Syndromes in HIV Patients Stable on Antiretroviral Therapy?
abstract: HIV(+) persons stable on antiretroviral therapy (ART) face early onset of age-related diseases. This may arise from a high burden of cytomegalovirus (CMV). To address the role of CMV, we investigated univariate and multivariate associations between markers of systemic and endothelial inflammation, vascular damage, insulin resistance (IR), neurocognitive decline, and antibodies reactive with CMV. In this study, HIV(+) participants (n = 91) aged >45 years with <50 copies HIV RNA/ml plasma after >2 years on ART were assessed for cardiovascular risk (the D:A:D algorithm), type II diabetes (the HOMA-IR index), and neurocognitive performance. Blood samples were assayed for lipids, T cells, insulin, glucose, C-reactive protein, CX3CL1, sTNF-R1, total immunoglobulin G (IgG), and antibodies reactive with CMV lysate, glycoprotein B, or immediate-early-1. Levels of antibodies detected with the three antigens were tightly correlated. Levels of CMV lysate antibody were higher in patients than in age-matched healthy controls and reflected their nadir CD4 T-cell count (p = .001), total IgG (p = .02), and age (p = .08). Levels of CMV lysate antibody correlated with D:A:D score (p = .04), neurocognitive performance (p = .045), and fasting insulin (p = .02). In multivariable analyses, some associations reflected the effect of age, but CMV lysate antibody and CD8 T-cell counts were significant predictors of the HOMA-IR index (R(2) = 0.09, p = .01) independent of age. We conclude that associations between levels of CMV antibodies, cardiovascular risk, and neurocognitive health in HIV(+) patients stable on ART are moderated by age-associated increases in response to CMV, while CMV antibodies may be independently linked with IR.
authors.affiliation: 1 Pathology and Laboratory Medicine, University of Western Australia , Nedlands, Australia .
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Brunt
authors.affiliation: 2 Peter Duncan Neurosciences Unit, St. Vincent's Applied Medical Research Centre , Sydney, Australia .|3 Neuroscience Research Australia , Sydney, Australia .|4 Faculty of Medicine, University of New South Wales , Sydney, Australia .
authors.forename: Lucette A
authors.initials: LA
authors.lastname: Cysique
authors.affiliation: 5 Microbiology and Infectious Diseases, Royal Perth Hospital , Perth, Australia .|6 School of Biomedical Science, Curtin University of Technology , Bentley, Australia .
authors.forename: Silvia
authors.initials: S
authors.lastname: Lee
authors.affiliation: 7 Medicine and Pharmacology, University of Western Australia , Nedlands, Australia .
authors.forename: Sally
authors.initials: S
authors.lastname: Burrows
authors.affiliation: 2 Peter Duncan Neurosciences Unit, St. Vincent's Applied Medical Research Centre , Sydney, Australia .|4 Faculty of Medicine, University of New South Wales , Sydney, Australia .|8 Neurology Department, St. Vincent's Hospital , Sydney, Australia .
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Brew
authors.affiliation: 6 School of Biomedical Science, Curtin University of Technology , Bentley, Australia .|7 Medicine and Pharmacology, University of Western Australia , Nedlands, Australia .
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
mesh_terms: D015526:AIDS Dementia Complex / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000914:Antibodies, Viral / Q000097:blood*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000276:immunology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D044966:Anti-Retroviral Agents; D000914:Antibodies, Viral