Mitchell Center for Alzheimer's disease and Related Brain Disorders, Department of Neurology, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Dement Geriatr Cogn Disord. 2022;51(6):467-474. doi: 10.1159/000527659. Epub 2023 Feb 6.
Approximately half of the people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HANDs). However, the neuropathogenesis of HAND is complex, and identifying reliable biomarkers has been challenging.
This study included 132 participants aged 50 and older from greater San Diego County. The participants were divided into three groups: PLWH with HAND (n = 29), PLWH without HAND (n = 73), and seronegatives without cognitive impairment (n = 30). Peripheral blood was collected at the clinical assessment, and plasma levels of neurofilament light chain (NfL), phosphorylated Tau 181 (pTau181), and glial fibrillary acidic protein (GFAP) were measured by enzyme-linked immunosorbent assay (ELISA).
Plasma levels of NfL (but not pTau181 and GFAP) were significantly associated with HAND at a medium effect size (p = 0.039, Cohen's d = 0.45 for HAND + vs. HAND-). Notably, higher levels of NfL were significantly associated with HAND diagnosis even after adjusting for sex.
Our data suggest that neuronal degeneration (as evidenced by increased levels of NfL), but not tau pathology or glial degeneration, is related to cognitive status in PLWH. Our results corroborate the view that blood NfL is a promising biomarker of cognitive impairment in PLWH.
约有一半的艾滋病毒感染者（PLWH）患有与艾滋病毒相关的神经认知障碍（HAND）。然而，HAND 的神经发病机制很复杂，并且一直难以确定可靠的生物标志物。
本研究纳入了来自圣地亚哥县的 132 名年龄在 50 岁及以上的参与者。参与者被分为三组：有 HAND 的 PLWH（n = 29）、无 HAND 的 PLWH（n = 73）和无认知障碍的血清阴性者（n = 30）。在临床评估时采集外周血，并通过酶联免疫吸附试验（ELISA）测量血浆神经丝轻链（NfL）、磷酸化 Tau 181（pTau181）和胶质纤维酸性蛋白（GFAP）的水平。
血浆 NfL 水平（而不是 pTau181 和 GFAP）与 HAND 呈中等效应大小相关（p = 0.039，HAND + 与 HAND-相比，Cohen's d = 0.45）。值得注意的是，即使在调整了性别因素后，NfL 水平较高仍与 HAND 诊断显著相关。
我们的数据表明，神经元退化（如 NfL 水平升高所证明）与 PLWH 的认知状态有关，而不是 tau 病理学或神经胶质退化。我们的结果证实了血液 NfL 是 PLWH 认知障碍的有前途的生物标志物的观点。
