Title:Lower CSF Aβ is Associated with HAND in HIV-Infected Adults with a Family History of Dementia
Volume: 14
Issue: 4
Author(s): Pariya. L. Fazeli, David J. Moore, Donald R. Franklin, Anya Umlauf, Robert K. Heaton, Ann C. Collier, Christina M. Marra, David B. Clifford, Benjamin B. Gelman, Ned C. Sacktor, Susan Morgello, David M. Simpson, John A. McCutchan, Igor Grant and Scott L. Letendre
Affiliation:
Keywords:
HIV, dementia, biomarkers, cerebrospinal fluid, family history, neurocognitive impairment.
Abstract: Background: Both family history of dementia (FHD) and lower levels of
Aβ-42 are indepentently associated with worse neurocognitive functioning in HIVinfected
patients.
Objective: To examine the relationships between cerebrospinal fluid (CSF) Aβ-42 and FHD with HIV-associated
neurocognitive disorders (HAND).
Methods: One hundred eighty-three HIV+ adults underwent neuropsychological and neuromedical assessments, and
determination of CSF Aβ-42 concentration and FHD (defined as a self-reported first or second-degree relative with a
dementia diagnosis). Univariate analyses and multivariable logistic regressions were used.
Results: FHD was not associated with HAND (p = 0.24); however, CSF Aβ-42 levels were lower (p = 0.03) in the HAND
group, but were not associated with FHD (p = 0.89). Multivariable models showed a main effect of CSF Aβ-42 (p = 0.03)
and a trend-level (p = 0.06) interaction between FHD and CSF Aβ-42, such that lower CSF Aβ-42 was associated with
HAND in those with FHD (p < 0.01) compared to those without FHD (p = 0.83). An analysis in those with follow-up data
showed that higher baseline CSF Aβ-42 was associated with lower risk of neurocognitive decline (p = 0.02). While we did
not find an FHD X CSF Aβ-42 interaction (p = 0.83), when analyses were stratified by FHD, lower CSF Aβ-42 was associated at
the trend-level with neurocognitive decline in the FHD group (p = 0.08) compared to the no FHD group (p = 0.15).
Conclusion: FHD moderates the relationship between of CSF Aβ-42 and HAND. The findings highlight the complexities
in interpreting the relationships between biomarkers of age-related neurodegeneration and HAND.
