Distinct cellular immune properties in cerebrospinal fluid are associated with cognition in HIV-infected individuals initiating antiretroviral therapy

Abstract

We examined the relationship between CSF immune cells and neurocognition and neuronal damage in HIV+ individuals before and after initiating antiretroviral therapy. Multivariate analysis at baseline indicated that greater CD4+ T cell abundance was associated with better cognition (p = .017), while higher CSF HIV RNA was associated with increased neuronal damage (p = .014). Following 24 weeks of antiretroviral therapy, CD8+ T cells, HLA-DR expressing CD4+ and CD8+ T cells, B cells, NK cells, and non-classical monocyte percentage decreased in CSF. Female gender was negatively associated with cognitive performance over time, as was higher percentage of HLA-DR expressing CD8+ T cells at baseline.

Keywords: AIDS; Cerebrospinal fluid; Cognition; Flow cytometry; HIV.

Fig. 1.

Gating Strategy.

Fig. 2.

CSF cytometry results by box and whisker plots comparing HIV+ at first visit (1) and HIVnegative (2). Box represents 25–75% range with median (horizontal line) and mean (O or +). Whiskers represent minimum and maximum. P < .05 for %CD4 + HLA-DR+, CD8+ and %CD8 + HLA-DR.

Fig. 3.

CSF cytometry results by box and whisker plots comparing HIV+ at second visit (1) and HIVnegative (2). Box represents 25–75% range with median (horizontal line) and mean (O or +). Whiskers represent minimum and maximum. P < .05 for CD8+ and %CD4 + HLA-DR+.