Inflammation Relates to Poorer Complex Motor Performance Among Adults Living With HIV on Suppressive Antiretroviral Therapy

Abstract

Background: Inflammatory processes have been suggested to underlie early neurologic abnormalities among persons living with HIV (HIV-positive), such as deficits in complex motor function, that are purported to remit with effective antiretroviral therapy (ART). We hypothesized that HIV will have negative direct and indirect effects through inflammation on complex motor performance.

Methods: The sample consisted of 90 ART-treated virally suppressed HIV-positive and 94 HIV-negative adults, aged 36-65 years, with balanced recruiting in each age decade (36-45, 46-55, and 56-65). Biomarkers of inflammation (d-dimer, IL-6, MCP-1/CCL2, sCD14, and TNF-α) were measured, and a composite inflammation burden score was calculated. Complex motor performance was evaluated using the Grooved Pegboard Test.

Results: The HIV-positive group had worse complex motor performance (P = 0.001; Hedges g = -0.49) and a higher average inflammation burden composite score (P < 0.001; Hedges g = 0.78) than the HIV-negative group. Path analyses indicated that the indirect effect of HIV disease on complex motor performance through inflammation burden was statistically significant, accounting for 15.1% of the effect of HIV on complex motor performance.

Conclusions: Although neurologic findings (eg, deficits in motor speed/dexterity) commonly associated with HIV infection typically remit with ART, our analysis indicates that inflammation plays an important role in worse complex motor skills among HIV-positive adults. Future studies of strategies for managing chronic inflammation in HIV should consider using an inflammation burden composite and examining its effect on complex motor performance.

Conflict of interest statement

Conflicts of Interest: For the remaining authors, none were declared.

Figures

Figure 1.

Path coefficients for mediation analysis of HIV serostatus to complex motor performance through inflammation burden for the overall sample (n=184). The dotted line denotes the direct path from HIV serostatus to complex motor performance when inflammation burden is not included as a mediator. a, b, c, and c’ are standardized OLS regression coefficients. Covariates were included in the analysis but are not depicted in the figure. *p < .05