Higher Cystatin C Levels Are Associated With Neurocognitive Impairment in Older HIV+ Adults. (1st March 2017)

• Record Type: Journal Article
• Authors: Sakoda, Marissa E.; Fazeli, Pariya L.; Ellis, Ronald J.; Jeste, Dilip V.; Grant, Igor; Letendre, Scott L.; Moore, David J.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 74:Number 3(2017)
• Publication Date: 2017-03-01
• Subjects: HIV/AIDS -- biomarkers -- cognition -- aging; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001235
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Objective: The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI). Methods: Participants included 124 (HIV+ n = 77; HIV− n = 47) older adults (age ≥ 50 years) examined at the University of California, San Diego HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI. Results: The HIV+ group had significantly higher cystatin C concentrations than the HIV− group (d = 0.79 P < 0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d = 0.42, P = 0.055), particularly among participants taking tenofovir (d = 0.78, P = 0.004). A receiver–operator characteristic curve identified that cystatin C levels ≥0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; P = 0.03). Conclusions: Our results confirm that HIV+ older adults have higher cystatin C than HIV− older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.