Recent findings published in JAMA Network Open propose that plasma biomarkers may serve as crucial indicators of brain health among individuals living with HIV (PLWH). The study highlights the potential of blood-based markers in discerning neurological conditions, particularly in the context of women with HIV.
Key Takeaways:
Significance of Plasma Biomarkers:
The study underscores the significance of plasma biomarkers as potential indicators of brain health in PLWH. This revelation opens avenues for utilizing blood-based markers in understanding and monitoring neurological conditions.
Effectiveness of Antiretroviral Therapies (ARTs):
While effective and timely prescription of ARTs has contributed to a reduction in HIV-associated neurocognitive disorders, older individuals living with HIV are still at risk of conditions such as Alzheimer’s disease (AD). This highlights the ongoing impact of HIV on brain health.
Risk in Women:
The study specifically addresses the risk faced by women, both with and without HIV, concerning adverse brain outcomes over time. It emphasizes the necessity of identifying blood-based AD biomarkers for early diagnosis, especially considering the potential increased risk in women living with HIV.
Cohort Study Overview:
The cohort study delves into the association between changes in plasma AD biomarkers and neuropsychological performance in women aged 40 and older. By adopting this approach, the research aims to bridge the gap between biological markers and clinical outcomes, providing a comprehensive understanding of brain health.
Findings:
Neuropsychological Performance:
The study reveals that women living with HIV exhibited poorer performance in memory, learning, verbal fluency, and overall neuropsychological function compared to women without HIV. This emphasizes the impact of HIV on cognitive abilities.
Impact of Antiretroviral Therapies:
Despite the positive impact of antiretroviral therapies in extending life expectancies among PLWH, HIV remains a public health concern globally, with over 38 million cases. Neurological disorders, including peripheral neuropathy and cognitive impairment, continue to be prevalent, highlighting the ongoing challenges associated with the virus.
Addressing Alzheimer’s Disease (AD):
Considering that over 50 million people worldwide experience AD, the seventh leading cause of death in the United States, the study aims to contribute to early diagnosis. Both women living with HIV (WLWH) and women living without HIV (WLWOH) may be at risk of adverse brain outcomes over time, emphasizing the importance of determining blood-based AD biomarkers.
Cohort Study Details:
Participants:
The cohort study involved women aged 40 and older, drawing data from the Women’s Interagency HIV Study (WIHS), a prospective study evaluating HIV in US women.
Sociodemographic and Clinical Characteristics:
Data encompassed various sociodemographic and clinical characteristics, including race, ethnicity, income, education, hypertension, diabetes, and substance use. HIV-related measures such as viral load, CD4 T cell count, and AIDS diagnosis were also considered.
Neurological Measures:
The study incorporated neurological measures such as depression, numb hands and feet, memory loss, confusion, and getting lost. Neuropsychological domains evaluated included attention, working memory, executive function, processing speed, memory, learning, verbal fluency, and fine motor skills.
Analysis and Results:
Study Participants:
The final analysis included 307 women, comprising 209 WLWH and 98 WLWOH. The majority of participants were aged over 50, with a significant percentage being Black and having a high school education or higher.
Performance Disparities:
WLWH exhibited lower scores in learning, memory, verbal fluency, and overall neuropsychological function compared to WLWOH. Notably, no AD or dementia diagnosis was observed at baseline.
Plasma Biomarkers:
At baseline, WLWH showed increased median plasma levels of Aβ40, GFAP, and NFL compared to WLWOH. Different associations were identified between biomarkers and cognitive functions, emphasizing the potential of plasma biomarkers in predicting brain health.
Conclusion:
In conclusion, the study offers valuable insights into the association between plasma biomarkers and brain health in women living with HIV. The findings underscore the ongoing impact of HIV on cognitive function and highlight the potential of blood-based markers in predicting neurological conditions. As research in this field progresses, these discoveries may contribute to early interventions and improved outcomes for individuals living with HIV, particularly women who face unique risks related to brain health.
