Abstract
Objectives: Despite combination antiretroviral therapy (cART) introduction, human immunodeficiency virus (HIV) patients have increased risk for neurocognitive impairment (NCI). However, NCI assessment methods in these patients have limitations. Many neurocognitive screening tests, although quicker, identify only the most severe form of impairment and are not suitable for early neurological disorder detection. We previously stated that determination of neutral lipids (NLs) by oil red O (ORO) staining in the cytoplasm of unstimulated peripheral blood mononuclear cells (PBMCs), combined with their tendency to cluster formation (CF), may represent a novel non-invasive approach to detect and monitor neuronal injury in the disease’s early stages. In an attempt to find rapid, feasible tools to screen for NCI in HIV patients, we determined ORO staining and CF in unstimulated PBMCs from HIV-infected adults. Methods: We analyzed demographic and clinical data including ORO and CF markers in 158 HIV-positive subjects receiving regular HIV infection care. Results: We found 45% of HIV patients have higher ORO score (2 to 4) and 46% higher CF score (1-2) compared to age-matched controls. As shown in our previous study, NL accumulation in PBMC cytoplasm appears correlated with cognitive impairment. Also in this HIV patient population, correlation of PBMC NL accumulation with cognitive performance reduction, as highlighted by RBANS, may be indicative of NCI. In addition, according to data given in literature, the prevalence of NCI in HIV patients is high (about 30 -60%). Conclusion: Our data shed light on the fact that as HIV patients have, as indicated by RBANS, lower cognitive performance than controls, and, in addition, that they have higher ORO and CF scores than controls, future studies are needed. Such studies might show that NL/CF screening, together with RBANS, could be useful for the rapid and practical detection of NCI in HIV-infected patients.
Highlights
Human immunodeficiency virus (HIV) is an infection that weakens the immune system, making it harder for the body to fight infections and disease
As shown in our previous study, neutral lipids (NLs) accumulation in peripheral blood mononuclear cells (PBMCs) cytoplasm appears correlated with cognitive impairment
Our data shed light on the fact that as HIV patients have, as indicated by RBANS, lower cognitive performance than controls, and, in addition, that they have higher oil red O (ORO) and cluster formation (CF) scores than controls, future studies are needed. Such studies might show that NL/CF screening, together with RBANS, could be useful for the rapid and practical detection of neurocognitive impairment (NCI) in HIV-infected patients
Summary
Human immunodeficiency virus (HIV) is an infection that weakens the immune system, making it harder for the body to fight infections and disease. With the advent of cART, the most severe forms of HIV-associated dementia significantly decreased in prevalence, but milder forms of impairment remain highly prevalent and increase with age, affecting about 30 - 60% of HIV patients [5,6]. It has, to be noted that there is current discussion about the prevalence of neurocognitive dysfunction, which might be under- or overestimated, depending on the neurocognitive assessment tools used. Understanding what can happen to the central nervous system (CNS) after many years of apparently controlled HIV represents an urgent and important challenge in the field of HIV medicine [8]
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