title: (1→3)-β-D-Glucan Levels Correlate With Neurocognitive Functioning in HIV-Infected Persons on Suppressive Antiretroviral Therapy: A Cohort Study.
abstract: Microbial translocation from the gut is associated with immune dysfunction, persistent inflammation, and likely plays a role in the pathogenesis of neurocognitive dysfunction during HIV infection. (1→3)-β-D-Glucan (BDG) is a component of most fungal cell walls and might be a useful indicator of gut mucosal barrier impairment. The objective of this study was to evaluate whether higher blood BDG levels correlate with impaired neurocognitive functioning in a cohort of HIV-infected adults with suppressed levels of HIV RNA in blood plasma. In this cross-sectional cohort study, we measured levels of BDG in blood plasma and cerebrospinal fluid (CSF) supernatant samples in a cohort of adults with acute/early HIV infection, who initiated antiretroviral therapy (ART) during the earliest phase of infection and achieved suppressed levels of HIV RNA in blood plasma (<50 copies/mL) thereafter. We compared BDG with established biomarkers of microbial translocation, immune activation, and cognitive dysfunction (evaluated by global deficit score). We found that higher blood BDG levels were significantly related to higher global deficit scores, reflecting worse neurocognitive performance (Spearman r = 0.47; P = 0.042) among HIV-infected adults with suppressed viral loads who initiated ART early in infection. Two CSF samples presented elevated BDG levels. Interestingly, these 2 samples originated from the 2 subjects with the highest global deficit scores of the cohort. BDG may be a promising independent biomarker associated with neurocognitive functioning in virologically suppressed HIV-infected individuals.
authors.affiliation: From the Department of Medicine, Division of Infectious Diseases, University of California San Diego, San Diego, CA (MH, MFDO, JP-S, SM, SG), Department of Internal Medicine, Section of Infectious Diseases and Tropical Medicine (MH), Department of Internal Medicine, Division of Pulmonology, Medical University of Graz, Graz, Austria (MH), Research Laboratory, Associates of Cape Cod, Inc, Falmouth, MA (YZ, MF), Department of Psychiatry (AJM, TDM), and Department of Neurosciences, HIV Neurobehavioral Research Center, University of California, San Diego, CA (RJE).
authors.forename: Martin
authors.initials: M
authors.lastname: Hoenigl
authors.forename: Michelli Faria
authors.initials: MF
authors.lastname: de Oliveira
authors.forename: Josué
authors.initials: J
authors.lastname: Pérez-Santiago
authors.forename: Yonglong
authors.initials: Y
authors.lastname: Zhang
authors.forename: Sheldon
authors.initials: S
authors.lastname: Morris
authors.forename: Allen J
authors.initials: AJ
authors.lastname: McCutchan
authors.forename: Malcolm
authors.initials: M
authors.lastname: Finkelman
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Sara
authors.initials: S
authors.lastname: Gianella
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000097:blood* / Q000134:cerebrospinal fluid; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000097:blood* / Q000134:cerebrospinal fluid / Q000188:drug therapy; D006801:Humans; D016209:Interleukin-8 / Q000097:blood / Q000134:cerebrospinal fluid; D018950:Lipopolysaccharide Receptors / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012367:RNA, Viral / Q000097:blood*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D047071:beta-Glucans / Q000097:blood* / Q000134:cerebrospinal fluid*
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D016209:Interleukin-8; D018950:Lipopolysaccharide Receptors; D012367:RNA, Viral; D047071:beta-Glucans