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- Title
Plasma Aβ42/Aβ40 Ratios in Older People With Human Immunodeficiency Virus.
- Authors
Cooley, Sarah A; Nelson, Brittany; Boerwinkle, Anna; Yarasheski, Kevin E; Kirmess, Kris M; Meyer, Matthew R; Schindler, Suzanne E; Morris, John C; Fagan, Anne; Ances, Beau M; O'Halloran, Jane A
- Abstract
Background As people with human immunodeficiency virus (HIV) (PWH) age, it remains unclear whether they are at higher risk for age-related neurodegenerative disorders—for example, Alzheimer disease (AD)—and, if so, how to differentiate HIV-associated neurocognitive impairment from AD. We examined a clinically available blood biomarker test for AD (plasma amyloid-β [Aβ] 42/Aβ40 ratio) in PWH who were cognitively normal (PWH_CN) or cognitively impaired (PWH_CI) and people without HIV (PWoH) who were cognitively normal (PWoH_CN) or had symptomatic AD (PWoH_AD). Methods A total of 66 PWH (age >40 years) (HIV RNA <50 copies/mL) and 195 PWoH provided blood samples, underwent magnetic resonance imaging, and completed a neuropsychological battery or clinical dementia rating scale. Participants were categorized by impairment (PWH_CN, n = 43; PWH_CI, n = 23; PWoH_CN, n = 138; PWoH_AD, n = 57). Plasma Aβ42 and Aβ40 concentrations were obtained using a liquid chromatography–tandem mass spectrometry method to calculate the PrecivityAD amyloid probability score (APS). The APS incorporates age and apolipoprotein E proteotype into a risk score for brain amyloidosis. Plasma Aβ42/Aβ40 ratios and APSs were compared between groups and assessed for relationships with hippocampal volumes or cognition and HIV clinical characteristics (PWH only). Results The plasma Aβ42/Aβ40 ratio was significantly lower, and the APS higher, in PWoH_AD than in other groups. A lower Aβ42/Aβ40 ratio and higher APS was associated with smaller hippocampal volumes for PWoH_AD. The Aβ42/Aβ40 ratio and APS were not associated with cognition or HIV clinical measures for PWH. Conclusions The plasma Aβ42/Aβ40 ratio can serve as a screening tool for AD and may help differentiate effects of HIV from AD within PWH, but larger studies with older PWH are needed.
- Subjects
HIV infection complications; ALZHEIMER'S disease diagnosis; BIOMARKERS; COGNITION disorders; ALZHEIMER'S disease; HIPPOCAMPUS (Brain); LIQUID chromatography; MAGNETIC resonance imaging; COGNITION; AMYLOID beta-protein precursor; COMPARATIVE studies; NEUROPSYCHOLOGICAL tests; RESEARCH funding; MASS spectrometry; SYMPTOMS; OLD age
- Publication
Clinical Infectious Diseases, 2023, Vol 76, Issue 10, p1776
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad001