ArticleAIDS (London, England)2026
Astrocyte/monocyte activation and inflammation are associated with asymptomatic neurocognitive impairment in people with HIV on suppressive antiretroviral therapy.
Article in AIDS (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveDespite suppressive antiretroviral therapy (ART), people with HIV (PWH) frequently experience neurocognitive impairment, yet underlying mechanisms remain elusive. We hereby evaluated biomarkers of brain injury, inflammation and gut barrier dysfunction to identify factors associated with cognitive performance in PWH.
designPWH on suppressive ART and people without HIV (PWoH) were cross-sectionally enrolled.
methodsPWH underwent a comprehensive neurocognitive assessment and HIV-associated neurocognitive disorder (HAND) was diagnosed. We measured plasma markers of neuroaxonal damage and astrocyte activation (NF-L/GFAP by Simoa), inflammation/monocyte activation (IP-10/IL-6/sCD14 by ELISA), gut barrier disruption (I-FABP/E-cadherin/zonulin by ELISA) and microbial translocation (LBP/EndoCAb IgG by ELISA). Non-parametric tests and multivariable regression were used for analyses.
resultsForty PWH [17 HAND+ (asymptomatic neurocognitive impairment), 23 HAND-] and 10 PWoH were included. Compared to PWoH, PWH had higher levels of inflammation/monocyte activation (IP-10/sCD14), gut barrier disruption (I-FABP) and microbial translocation (LBP/EndoCAb-IgG). PWH HAND+ showed higher levels of GFAP/IL-6/sCD14 compared to PWH HAND-. At logistic regression adjusting for age, sex and CD4 T-cell nadir , HAND confirmed associated with higher GFAP/sCD14. More specifically, at linear regression adjusting for the same variables, higher GFAP levels were associated with lower global cognitive performance, worse attention and working memory, speed of information processing, motor skills, as well as learning and memory; higher IL-6 with worse abstraction and executive functions; higher IL-6 and sCD14 with worse verbal fluency.
conclusionIn our cohort of ART-suppressed PWH, asymptomatic neurocognitive impairment was associated with markers of astrocyte/monocyte activation and inflammation rather than with markers of neuroaxonal damage, gut barrier disruption, or microbial translocation.
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