Hepcidin modifies the relationship between anemia, erythrocyte indices, and neurocognitive performance in virally suppressed people with HIV.

IF 3.1 2区 医学 Q3 IMMUNOLOGY AIDS Pub Date : 2025-05-01 Epub Date: 2025-01-06 DOI:10.1097/QAD.0000000000004110
Azin Tavasoli, Oluwakemi K Okwuegbuna, Bin Tang, Jennifer E Iudicello, Asha R Kallianpur, Ronald J Ellis, Scott L Letendre
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Abstract

Objective: Neurocognitive impairment in people with HIV (PWH) is associated with erythrocyte indices, which may serve as indicators of iron metabolism, inflammation, and related factors. Erythropoiesis requires iron, regulated by a multifaceted system of peptide hormones, including hepcidin. This study postulated that hepcidin might modify the relationship between erythrocyte indices and neurocognitive performance in PWH.

Methods: Plasma hepcidin and erythrocyte indices were quantified in 88 virally suppressed PWH who underwent comprehensive neurocognitive assessments. Global neurocognitive performance was summarized by global T -scores. Associations of global T -scores with anemia and erythrocyte indices were determined in univariable analyses. To examine the influence of hepcidin on the relationship between neurocognitive performance and erythrocyte indices, we evaluated interactions between these covariates in relation to global T -scores and then performed stratified analyses.

Results: In multivariable analyses, hepcidin detectability interacted with age ( P  = 0.007) and mean corpuscular volume (MCV; P  = 0.031) in relation to the global T -score. Interactions between anemia and erythrocyte indices on global T -scores were significant (anemia × MCV, P  = 0.008; anemia × MCH, P  = 0.011). Stratified analyses identified that lower global T -scores were associated with older age ( P  = 0.001) and higher MCV ( P  = 0.0046) and mean corpuscular hemoglobin (MCH, P  = 0.026) only when hepcidin was undetectable. Among the anemic, worse global T -score was associated with higher MCV ( P  = 0.001) and MCH ( P  = 0.002).

Conclusion: Findings suggest that iron-related factors (hepcidin, anemia, MCV, MCH) and age influence neurocognitive health. This cross-sectional study underscores hepcidin as an effect modifier in the associations of erythrocyte indices, anemia, and age with neurocognitive function in PWH.

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Hepcidin改变了HIV病毒抑制患者贫血、红细胞指数和神经认知表现之间的关系。
目的:HIV感染者(PWH)神经认知功能障碍与红细胞指标相关,红细胞指标可作为铁代谢、炎症及相关因素的指标。红细胞生成需要铁,铁是由多肽激素(包括hepcidin)的多方面系统调节的。本研究推测hepcidin可能改变PWH红细胞指数与NC性能之间的关系。方法:对88例病毒抑制的PWH患者进行NC综合评估,测定其血浆hepcidin和红细胞指标。整体NC表现用整体t评分进行总结。在单变量分析中确定了总体t评分与贫血和红细胞指数的关联。为了检验hepcidin对NC表现和红细胞指数之间关系的影响,我们评估了这些协变量与全局t评分之间的相互作用,然后进行了分层分析。结果:在多变量分析中,hepcidin的检出率与年龄(p = 0.007)和平均红细胞体积(MCV) (p = 0.031)相互作用。贫血和红细胞指数对整体t评分的相互作用显著(贫血x MCV, p = 0.008;贫血x MCH, p = 0.011)。分层分析发现,只有在hepcidin检测不到的情况下,较低的总体t评分与年龄较大(p = 0.001)、MCV较高(p = 0.0046)和平均红细胞血红蛋白(MCH, p = 0.026)相关。在贫血患者中,较差的总体t评分与较高的MCV (p = 0.001)和MCH (p = 0.002)相关。结论:铁相关因素(hepcidin、贫血、MCV、MCH)和年龄影响神经认知健康。这项横断面研究强调了hepcidin在PWH中红细胞指数、贫血和年龄与神经认知功能的关联中是一种效应调节剂。
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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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