Plasma Aβ42/Aβ40 ratios are not reduced in older people living with HIV

alexandrossfakianakis shared this article with you from Inoreader Plasma Aβ42/Aβ40 ratios are not reduced in older people living with HIV via Clinical Infectious Diseases Advance Access Abstract Background As people with HIV (PWH) age, it remains unclear whether they are at higher risk for age-related neurodegenerative disorders, e.g., Alzheimer disease (AD), and if so, how to differentiate HIV-associated neurocognitive impairment from AD. We examined a clinically-available blood biomarker test for AD (plasma Aβ42/Aβ40 ratio), in cognitively-normal (CN) or cognitively-impaired (CI) PWH and people without HIV (PWoH) who were CN or with symptomatic AD. Methods 66 PWH (age >40 years) (HIV RNA <50 copies/mL) and 195 PWoH provided blood samples, magnetic resonance imaging (MRI), and completed a neuropsychological battery or Clinical Dementia Rating scale (CDR). Participants were categorized by impairment (PWH_CN n = 43; PWH_CI n = 23; PWoH_CN n = 138; PWoH_AD n = 57). Plasma Aβ42 and Aβ40 concentrations were obtained using a liquid chromatography-tandem mass spectrometry method to calculate the PrecivityAD® Amyloid Probability Score (APS). The APS incorporates age and apolipoprotein E proteotype into a risk score for brain amyloidosis. Plasma Aβ42/Aβ40 and APS were compared between groups and assessed for relationships with hippocampal volumes or cognition and HIV clinical characteristics (PWH only). Results The plasma Aβ42/Aβ40 ratio was significantly lower, and APS higher, in PWoH_AD compared to other groups. A lower Aβ42/Aβ40 ratio and higher APS was associated with smaller hippocampal volumes for PWoH_AD. The Aβ42/Aβ40 ratio and APS were not associated with cognition or HIV clinical measures for PWH. Conclusions The plasma Aβ42/Aβ40 ratio can serve as a screening tool for AD and may help differentiate effects of HIV from AD within PWH, but larger studies with older PWH are needed. View on Web

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