High Plasma Soluble CD163 During Infancy Is a Marker for Neurocognitive Outcomes in Early-Treated HIV-Infected Children
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Date
2019
Authors
Benki-Nugent, Sarah F.
Martopullo, Ira
Laboso, Tony
Tamasha, Nancy
Wamalwa, Dalton C.
Tapia, Kenneth
Langat, Agnes
Obimbo, Elizabeth Maleche
Marra, Christina M.
Bangirana, Paul
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of acquired immune deficiency syndromes
Abstract
Monocyte activation may contribute to neuronal injury in aviremic HIV-infected adults; data are lacking in children. We examined the relation between monocyte activation markers and early and long-term neurodevelopmental outcomes in early-treated HIV-infected children.Prospective study of infant and child neurodevelopmental outcomes nested within a randomized clinical trial () and extended cohort study in Kenya.HIV-infected infants (N=67) initiated ART at age <5 months. Plasma soluble (s) CD163 (sCD163), sCD14 and neopterin were measured pre-ART (entry) and 6 months later. Milestone attainment was ascertained monthly during 24 months and neuropsychological tests (NPTs) were performed at 5.8–8.2 years post-initiation of ART (N=27). The relationship between neurodevelopment and sCD163, sCD14 and neopterin at entry and 6 months post-ART was assessed using Cox proportional hazards models and linear regression.Infants with high entry sCD163 had unexpected earlier attainment of supported sitting (5 vs 6 mo.; P=0.006) and supported walking (10 vs 12 mo.; P =0.02) with trends in adjusted analysis. Infants with high 6-month post-ART sCD163 attained speech later (17 vs 15 mo.; P=0.006; aHR, 0.47; P=0.02), threw toys later (18 vs 17 mo.; P =0.01; aHR, 0.53; P =0.04), and at median 6.8 years post-ART, had worse NPT scores (adj. mean z-score differences, cognition, −0.42; P =0.07; short-term memory, −0.52; P =0.08; nonverbal test performance, −0.39, P =0.05).Prior to ART, monocyte activation may reflect transient neuroprotective mechanisms in infants. Following ART and viral suppression, monocyte activation may predict worse short- and long-term neurodevelopment outcomes.
Description
Keywords
monocyte, neurocognitive, antiretroviral, perinatal HIV, CD163, neurodevelopment
Citation
Benki-Nugent, S. F., Martopullo, I., Laboso, T., Tamasha, N., Wamalwa, D. C., Tapia, K., ... & John-Stewart, G. C. (2019). High plasma soluble CD163 during infancy is a marker for neurocognitive outcomes in early treated HIV-infected children. Journal of acquired immune deficiency syndromes (1999), 81(1), 102.https://dx.doi.org/10.1097%2FQAI.0000000000001979