CSF biomarkers of Alzheimer disease in HIV-associated neurologic disease.
Title | CSF biomarkers of Alzheimer disease in HIV-associated neurologic disease. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Clifford, DB, Fagan, AM, Holtzman, DM, Morris, JC, Teshome, M, Shah, AR, Kauwe, JSK |
Journal | Neurology |
Volume | 73 |
Issue | 23 |
Pagination | 1982-7 |
Date Published | 2009 Dec 08 |
ISSN | 1526-632X |
Keywords | Adult, Aged, Aged, 80 and over, Alzheimer Disease, Amyloid beta-Peptides, Biomarkers, CHARTER, Cohort Studies, External, HIV Infections, Humans, Middle Aged, Nervous System Diseases, tau Proteins |
Abstract | BACKGROUND: HIV-associated neurologic disorders (HAND) continue to develop in many patients with HIV. CSF amyloid measurements in HAND have been reported to be similar to those in dementia of the Alzheimer type (DAT). Confirmatory evaluation of this finding in carefully evaluated subjects is needed.METHODS: CSF specimens were obtained from subjects clinically categorized with normal cognition from the general population, HIV+ subjects with normal cognition, HIV+ subjects with impaired cognition, or presumed HIV- subjects with mild DAT. CSF measurements of beta-amyloid((1-42)) (Abeta42), beta-amyloid((1-40)) (Abeta40), total tau (t-tau), and phosphorylated tau (p-tau181) were performed.RESULTS: CSF Abeta42 measured in 49 HAND subjects had a median level of 501 pg/mL, which was lower than that of 50 controls of similar age who had median of 686 pg/mL (p < 0.0001) or 21 HIV+ subjects without cognitive impairment who had median of 716 pg/mL (p < 0.003). HAND subjects had similar CSF Abeta42 to 68 subjects with mild DAT. There was no difference of CSF Abeta40 between the groups. Tau and p-tau181 was elevated in DAT, but slightly lower than control in both HIV+ groups.CONCLUSIONS: beta-Amyloid((1-42)) (Abeta42) measurements in CSF of cognitively impaired patients with HIV are similar to those in patients with mild dementia of the Alzheimer type (DAT). Normal or slightly depressed CSF tau and p-tau181 measurements distinguish these patients with HIV-associated neurologic disorders (HAND) from patients with DAT. Further evaluation of amyloid metabolism in patients with HIV cognitive disorder is needed to understand the implications of depressed CSF Abeta42 in the setting of HAND. |
DOI | 10.1212/WNL.0b013e3181c5b445 |
Alternate Journal | Neurology |
PubMed ID | 19907013 |
PubMed Central ID | PMC2790234 |
Grant List | P50 AG05681 / AG / NIA NIH HHS / United States MH 22005 / MH / NIMH NIH HHS / United States P01 AG026276 / AG / NIA NIH HHS / United States R24MH59724 / MH / NIMH NIH HHS / United States P50 AG005681 / AG / NIA NIH HHS / United States R24NS45491 / NS / NINDS NIH HHS / United States P01 AG03991 / AG / NIA NIH HHS / United States MH05745 / MH / NIMH NIH HHS / United States U01 MH083545 / MH / NIMH NIH HHS / United States NS32228 / NS / NINDS NIH HHS / United States NS38841 / NS / NINDS NIH HHS / United States |