Cerebrospinal fluid biomarkers of inflammation and immune activation associated with neurocognitive impairment among U.S. Latinos living with HIV.

Abstract

Objective: Examine the association between markers of inflammation in the cerebrospinal fluid (CSF) and neurocognitive impairment (NCI) among diverse persons with HIV (PWH).

Background: Latino PWH are at higher risk for NCI than non-Latino White PWH (NLW). Evidence of inflammation in cerebrospinal fluid (CSF) can be higher among racial and ethnic minority PWH and has been linked to NCI.

Methods: We performed a retrospective cross-sectional analysis of 363 PWH who identified as Latinos or NLW. Neurocognitive performance was measured by a comprehensive battery. A focused panel of biomarkers [interleukin-6 (IL-6), soluble CD14 (sCD14), interferon-γ-inducible protein-10 (IP-10), neurofilament light chain (NFL)] was measured in CSF by immunoassay. Covariates included demographic, HIV disease, medical, psychiatric, and substance use characteristics.

Results: The cohort consisted of 126 Latinos and 237 NLW (age: M = 42.5, SD = 11.0, 88% male, 51.5% AIDS history; 64% on antiretroviral therapy). Latinos had significantly higher NFL levels than NLW (P < 0.0001, adjusted Cohen's d 1.15), but not among virally-suppressed PWH. In the entire cohort, higher sCD14 was associated with NCI (adjusted odds ratio (aOR) = 2.6, confidence interval (CI) = 1.1-6.5] after adjusting for statistically significant covariates.

Conclusions: We did not identify a relationship between ethnicity, inflammation and NCI in this cohort. Future studies might examine sociocultural factors leading to increased inflammation in the CSF in diverse PWH.