학술논문

Asymptomatic Malaria Co-infection of HIV-Infected Adults in Nigeria: Prevalence of and Impact on Cognition, Mood, and Biomarkers of Systemic Inflammation.
Document Type
article
Source
JAIDS Journal of Acquired Immune Deficiency Syndromes. 86(1)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Clinical Sciences
HIV/AIDS
Behavioral and Social Science
Neurosciences
Depression
Brain Disorders
Clinical Research
Mental Health
Infectious Diseases
Evaluation of treatments and therapeutic interventions
Aetiology
6.1 Pharmaceuticals
2.1 Biological and endogenous factors
Mental health
Infection
Good Health and Well Being
Adult
Asymptomatic Infections
Biomarkers
Cognition
Coinfection
Cross-Sectional Studies
Female
HIV Infections
Humans
Inflammation
Lipopolysaccharide Receptors
Malaria
Male
Nigeria
Prevalence
Prospective Studies
asymptomatic malaria
HIV co-infection
HIV-associated neurocognitive disorders
soluble CD14
soluble CD163
Public Health and Health Services
Virology
Clinical sciences
Epidemiology
Public health
Language
Abstract
BackgroundHIV and malaria are associated with immunological perturbations and neurocognitive disorders even when asymptomatic. However, the effect of asymptomatic malaria (AM) in HIV-infected adults on neurocognitive impairment (NCI) is not well understood. This study investigated the biomarkers of systemic inflammation and neurocognition in dually infected Nigerian adults.MethodsWe assessed the HIV and AM status of 269 adults and measured their global and domain-specific neurocognition and depression using standardized measures. Blood levels of sCD14 and sCD163 were also measured.ResultsThe mean age of the participants (n = 269) was 33 years, 62% were women, and AM among HIV+ and HIV- was similar (36% versus 37%). NCI was found in 23% (62/269) of participants. HIV+/AM+ had a higher prevalence of impaired learning and executive functions and were more depressed than HIV-/AM- or HIV+/AM-. HIV+ with CD4 T-cell counts ≤200/µL were more impaired in the learning domain than those with >200/µL. HIV+/AM+ group had higher levels of sCD14 compared to the other 3 groups and higher levels of sCD163 than the HIV-/AM- group. Higher levels of sCD14 and sCD163 were each associated with NCI. The sCD163 (log10) levels were higher for those with 1+ versus 2+ parasitemia level.ConclusionsHIV and AM coinfection was associated with an increased risk of reduced learning and executive functions, and elevated systemic inflammation. Mood was more depressed in HIV patients with than those without AM. The mechanisms and long-term effects on neurocognition and depression among HIV+/AM+ individuals should be studied because this coinfection is common globally.