Soluble Biomarkers of Cognition and Depression in Adults with HIV Infection in the Combination Therapy Era

Abstract

Purpose of review: Cognitive impairment and depression continue to be common among people with HIV (PWH) in the combination antiretroviral therapy (ART) era. A better understanding of the biological mechanisms that may underpin these disorders is needed. The purpose of this review is to describe published findings on soluble biomarkers from blood and cerebrospinal fluid (CSF) that have been associated with either cognition or depression among PWH in the setting of ART.

Recent findings: Several biomarkers, including those that reflect viral persistence, monocyte/macrophage activation, and other processes, are associated with cognition and depressive symptoms. Some but not all results have been consistent across multiple studies. More research has been published on biomarkers of cognition relative to biomarkers of depression (particularly from CSF). More studies are needed that investigate multiple biomarkers to understand the role of distinct but additive pathways in these disorders and to guide the development of new therapies.

Keywords: AIDS; Biomarkers; Cerebrospinal fluid; HIV; Neurocognitive disorders.

Fig. 1

CSF-plasma HIV discordance is associated with worse cognitive performance

Fig. 2

A persistently undetectable CSF HIV RNA was associated with cognitive improvement