Relationships between markers of vascular dysfunction and neurodevelopmental outcomes in perinatally HIV-infected youth
Suad Kapetanovic, Erin Leister, Sharon Nichols, Tracie Miller, Katherine Tassiopoulos, Rohan Hazra, Harris A Gelbard, Kathleen M Malee, Betsy Kammerer, Armando J Mendez, Paige L Williams, Pediatric HIV/AIDS Cohort Study Team, George Seage, Julie Alperen, Russell Van Dyke, Kenneth Rich, Patrick Davis, Suzanne Siminski, Mercy Swatson, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Noycze, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Robin McEvoy, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Gwendolyn Scott, Lisa Himic, Elizabeth Willen, Suad Kapetanovic, Erin Leister, Sharon Nichols, Tracie Miller, Katherine Tassiopoulos, Rohan Hazra, Harris A Gelbard, Kathleen M Malee, Betsy Kammerer, Armando J Mendez, Paige L Williams, Pediatric HIV/AIDS Cohort Study Team, George Seage, Julie Alperen, Russell Van Dyke, Kenneth Rich, Patrick Davis, Suzanne Siminski, Mercy Swatson, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Noycze, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Robin McEvoy, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Gwendolyn Scott, Lisa Himic, Elizabeth Willen
Abstract
Objective: To examine the relationship between markers of vascular dysfunction and neurodevelopmental status in pediatric HIV disease.
Design: A cross-sectional design within a prospective, 15-site cohort study conducted in the United States.
Methods: Nine vascular biomarkers were examined in 89 HIV-infected children: soluble P-selectin/sCD62P, fibrinogen, adiponectin, monocyte chemoattractant protein-1/CCL-2, interleukin-6, C-reactive protein, soluble vascular cell adhesion molecule-1/sCD106, sE-selectin/sCD62E, and soluble intercellular adhesion molecule-1/sCD54. The Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) was administered yielding indices for verbal comprehension, perceptual reasoning, working memory and processing speed, and overall composite Full-Scale IQ score. Linear regression models were used to evaluate neurodevelopmental status (measured by WISC-IV scores) as a function of each biomarker while adjusting for demographics, disease severity, and receipt of HAART. Biomarker levels were evaluated in quartiles to evaluate trends in WISC-IV responses.
Results: Among the 89 HIV-infected children (median age = 12 years), 56% were girls, 71% black, 16% Hispanic, and 43% had yearly household income below US $20,000. Log (soluble P-selectin) was significantly correlated with all WISC-IV scores; adjusted slopes showed 6-11-point average decrease in scores for each one log unit increase in soluble P-selectin. Final linear regression models for log (fibrinogen) adjusted for sociodemographic and disease characteristics also indicated a negative correlation with all WISC-IV scores (13-30-point decrease for each one log unit increase in fibrinogen); these decreases were significant in the verbal comprehension, perceptual reasoning, and Full-Scale IQ scores.
Conclusion: Proinflammatory microvascular and immunologic mechanisms may be involved in neurodevelopmental impairment in children with perinatally acquired HIV disease.
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Source: PubMed