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Vascular injury markers associated with cognitive impairment in people with HIV on suppressive antiretroviral therapy
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Nov 2023
Guha, Debjania; Misra, Vikasa; Yin, Juna; Horiguchi, Mikib; Uno, Hajimeb; Gabuzda, Danaa,c
In summary, we present evidence that peripheral markers of vascular injury are more closely associated with HAND and CNS injury in PWH on suppressive ART than markers of inflammation. Our findings are consistent with the three-hit model proposed by Jakabek et al.[20] in which HIV infection, aging, and vascular disease contribute to brain aging in PWH, and suggest that vascular injury markers, particularly VCAM-1, may help to distinguish relative contributions of VCI to HAND. Further studies are warranted to better understand the utility of VCAM-1 and other peripheral markers of vascular injury for identification of HAND biotypes [11,13] and development of tailored interventions in virally suppressed PWH on ART.
These findings suggest that vascular injury markers have a stronger association with cognitive impairment and CNS injury in virally suppressed PWH than inflammation markers and may help to distinguish relative contributions of VCI to HAND.
Markers of endothelial dysfunction, including VCAM-1 and ICAM-1, are predictors of severity and progression of vascular disease and have been associated with VCI in the general population [47]. Furthermore, increased VCAM-1 was associated with deficits in executive function, processing speed, and working memory in a recent study of 84 PWH [25].
HIV, Vascular and Aging Injuries in the Brain of Clinically Stable HIV-Infected Adults: A 1H MRS Study Published: April 19, 2013, Lucette Cysique
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