Plasma inflammatory biomarkers lack strong association with cognitive outcomes among young adults with perinatal HIV exposure and/or acquisition

Abstract

Background: Our objective was to evaluate the association between inflammatory biomarkers and NIH Toolbox cognitive outcomes in young adults with perinatal HIV exposure but uninfected (YAPHEU) and those with perinatal HIV (YAPHIV), with or without prior HIV disease progression. Setting: We analyzed participants with plasma samples and NIH Toolbox cognitive scores at entry into a multisite longitudinal cohort in the United States. Methods: Participants were subdivided into groups by HIV status: YAPHIV who experienced a stage 3 event (YAPHIV-W3, indicating history of HIV disease progression), YAPHIV who had not (YAPHIV-WO3), and YAPHEU. Fifteen biomarkers were measured. Principal component analysis was used to derive biomarker principal component (PC) scores, with 4 PCs retained, accounting for 67% of the variance within biomarker correlations. We computed Pearson correlations of individual log-transformed biomarkers and PCs with NIH Toolbox Total, Fluid, and Crystallized Cognition Composite Scores, separately by HIV status. Results: A total of 638 participants (135 YAPHIV-W3, 383 YAPHIV-WO3, 117 YAPHEU, and 3 YAPHIV without stage 3 information) met eligibility criteria. The median age was 20.6 years (Interquartile Range 18.6-24.6), and 60% (n = 381) were female. In both YAPHIV-WO3 and YAPHIV-W3, PC3 was weakly negatively correlated with Fluid and Total Cognition Composite Scores. In YAPHIV-W3, PC2 was also weakly negatively associated with Fluid Cognition. In YAPHEU, PC1 was weakly positively correlated with Fluid Cognition and weakly negatively correlated with Crystallized Cognition. Conclusions: No inflammatory biomarkers or summary score measures showed meaningful associations with worse cognitive outcomes in a population with long-term perinatal HIV acquisition or exposure.