Associations between Cognition, Gender and Monocyte Activation among HIV Infected Individuals in Nigeria

Abstract

The potential role of gender in the occurrence of HIV-related neurocognitive impairment (NCI) and associations with markers of HIV-related immune activity has not been previously examined. In this study 149 antiretroviral-naïve seropositive subjects in Nigeria (SP, 92 women and 57 men) and 58 seronegative (SN, 38 women and 20 men) were administered neuropsychological testing that assessed 7 ability domains. From the neuropsychological test scores was calculated a global deficit score (GDS), a measure of overall NCI. Percentages of circulating monocytes and plasma HIV RNA, soluble CD163 and soluble CD14 levels were also assessed. HIV SP women were found to be younger, more educated and had higher CD4+ T cell counts and borderline higher viral load measures than SP men. On the neuropsychological testing, SP women were more impaired in speed of information processing and verbal fluency and had a higher mean GDS than SN women. Compared to SP men, SP women were also more impaired in speed of information processing and verbal fluency as well as on tests of learning and memory. Numbers of circulating monocytes and plasma sCD14 and sCD163 levels were significantly higher for all SP versus all SN individuals and were also higher for SP women and for SP men versus their SN counterparts. Among SP women, soluble CD14 levels were slightly higher than for SP men, and SP women had higher viral load measurements and were more likely to have detectable virus than SP men. Higher sCD14 levels among SP women correlated with more severe global impairment, and higher viral load measurements correlated with higher monocyte numbers and sCD14 and sCD14 levels, associations that were not observed for SP men. These studies suggest that the risk of developing NCI differ for HIV infected women and men in Nigeria and, for women, may be linked to effects from higher plasma levels of HIV driving activation of circulating monocytes.

Plasma HIV RNA level is associated with neurocognitive function among HIV-1-infected patients in Nigeria

“…Details of these are described in our other reports (Akolo et al 2014; Royal et al 2016; Jumare et al 2017). Participants were screened for effort using the Hiscock Digit Memory Test, and for depression with the Beck Depression Inventory (Beck et al 1996).…”

Progression of temporal processing deficits in the HIV-1 transgenic rat

“…Sex differences in the HIV-1 Tg rat expand on differences observed in HIV-1 seropositive individuals. Recent studies have reported significantly greater neurological impairment in HIV-1 seropositive women, in comparison to HIV-1 seropositive men4344. The effect of sex on the progression of neurocognitive impairments in HIV-1 seropositive individuals has been relatively understudied; the need for longitudinal study is critical45.…”

Sex differences in HIV effects on visual memory among substance-dependent individuals

“…A recent report from the Women’s Interagency HIV Study (WIHS), the largest study ( N = 1521) of HIV disease progression in women to date (Maki et al, 2014) demonstrated that HIV+ women performed significantly more poorly than HIV–women on measures of verbal episodic memory, but not on measures of processing speed (Symbol Digit Modalities Test) or executive functioning (Stroop, Trail Making Test B), which are typically impaired among HIV+ men (Woods et al, 2009). Maki et al (2014) speculated that verbal memory deficits might be more prominent among HIV+ women than among men, but limited evidence is available to address this question, since few studies have compared neurocognitive performance of HIV+ men and women directly (Behrman-Lay et al, 2016; Hestad et al, 2012; Robertson et al, 2005; Royal et al, 2004) with inconsistent results.…”