Lower CSF Aβ is Associated with HAND in HIV-Infected Adults with a Family History of Dementia

Author(s): Pariya. L. Fazeli, David J. Moore, Donald R. Franklin, Anya Umlauf, Robert K. Heaton, Ann C. Collier, Christina M. Marra, David B. Clifford, Benjamin B. Gelman, Ned C. Sacktor, Susan Morgello, David M. Simpson, John A. McCutchan, Igor Grant, Scott L. Letendre.

Journal Name: Current HIV Research

Volume 14 , Issue 4 , 2016

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Abstract:

Background: Both family history of dementia (FHD) and lower levels of Aβ-42 are indepentently associated with worse neurocognitive functioning in HIVinfected patients.

Objective: To examine the relationships between cerebrospinal fluid (CSF) Aβ-42 and FHD with HIV-associated neurocognitive disorders (HAND).

Methods: One hundred eighty-three HIV+ adults underwent neuropsychological and neuromedical assessments, and determination of CSF Aβ-42 concentration and FHD (defined as a self-reported first or second-degree relative with a dementia diagnosis). Univariate analyses and multivariable logistic regressions were used.

Results: FHD was not associated with HAND (p = 0.24); however, CSF Aβ-42 levels were lower (p = 0.03) in the HAND group, but were not associated with FHD (p = 0.89). Multivariable models showed a main effect of CSF Aβ-42 (p = 0.03) and a trend-level (p = 0.06) interaction between FHD and CSF Aβ-42, such that lower CSF Aβ-42 was associated with HAND in those with FHD (p < 0.01) compared to those without FHD (p = 0.83). An analysis in those with follow-up data showed that higher baseline CSF Aβ-42 was associated with lower risk of neurocognitive decline (p = 0.02). While we did not find an FHD X CSF Aβ-42 interaction (p = 0.83), when analyses were stratified by FHD, lower CSF Aβ-42 was associated at the trend-level with neurocognitive decline in the FHD group (p = 0.08) compared to the no FHD group (p = 0.15).

Conclusion: FHD moderates the relationship between of CSF Aβ-42 and HAND. The findings highlight the complexities in interpreting the relationships between biomarkers of age-related neurodegeneration and HAND.

Keywords: HIV, dementia, biomarkers, cerebrospinal fluid, family history, neurocognitive impairment.

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Article Details

VOLUME: 14
ISSUE: 4
Year: 2016
Page: [324 - 330]
Pages: 7
DOI: 10.2174/1570162X14666151221145926
Price: $58

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