Vascular and inflammatory biomarkers linked to neurocognition in Ugandan youth with perinatal HIV on dolutegravir.

OBJECTIVES

To examine associations of immune biomarkers with neurocognition among Ugandan Youth living with Perinatally acquired HIV (YPHIV) virally suppressed on dolutegravir (DTG) versus Youth Without HIV (YWoH).

METHODS

In this cross-sectional study of 101 age- and sex-matched youth in Kampala, Uganda (49 YPHIV, 52 YWoH), neurocognition was assessed using NeuroScreen. Biomarkers were measured using LEGENDplex™ and ELISA. Group differences were assessed using Wilcoxon rank-sum tests. Associations were evaluated using Spearman correlations and multivariable linear regression.

RESULTS

Median age was 16.9 years [IQR 15.1-17.1]. YPHIV performed worse across all neurocognitive domains (P ≤ 0.035). IFAB, MIP-3α, and RANTES were higher among YPHIV (P ≤ 0.024). In adjusted YPHIV models, myeloperoxidase was associated with worse processing speed (β = -3.24, 95% CI = -4.89, -1.58), learning and memory (β = -3.53, 95% CI = -6.48, -0.59), and global z-scores (β = -1.64, 95% CI = -2.78, -0.51); soluble CD14 (sCD14) with worse processing speed (β = -0.78, 95% CI = -1.55, -0.01); β-d-Glucan (BDG) with worse learning and memory (β = -0.35, 95% CI = -0.68, -0.03).

CONCLUSIONS

Ugandan YPHIV demonstrated worse neurocognitive performance. Biomarkers linked to HIV-related mortality and cardiovascular disease (MPO, sCD14, BDG) were associated with poorer performance.