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The following is a summary of “Plasma Neurofilament Light Chain and Glial Fibrillary Acidic Protein as Biomarkers of Cognitive Decline in People With Human Immunodeficiency Virus,” published in the December 2024 issue of Infectious Disease by Mukerji et al. 

Researchers conducted a retrospective study to examine the relationship between neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and cognition in individuals with human immunodeficiency virus (HIV) at baseline and over time.  

They used plasma and clinical data from virally suppressed people with HIV (PWH) aged ≥45 years from the AIDS Clinical Trials Group HAILO study, 4 neuropsychological assessments (NPZ-4) were used to measure cognition, with plasma collection marking the baseline. Slope analysis was used to summarize longitudinal changes in NPZ-4. Linear regressions examined the associations between biomarkers and both baseline NPZ-4 and longitudinal changes.  

The results showed that 503 participants had a median age of 52 (interquartile range [IQR, 48–57]) years and were observed for a median of 6 (IQR, 5–7) years. Of these, 26% had baseline cognitive impairment as defined by HAILO. Cross-sectional analysis revealed that higher NfL (β = −0.76, P < .01) and GFAP (β = −0.44, P = .02) were linked to worse NPZ-4 scores. Longitudinally, the median NPZ-4 slope was 0.003 (IQR, −0.06 to 0.06) units/year, with 48% showing cognitive decline. Higher NfL (β = −0.08, P < .01) was associated with cognitive decline, but GFAP (β = −0.03, P = .08) was not.  

Investigators concluded that NfL and GFAP were associated with worse cognition cross-sectionally, only NfL was linked to cognitive decline, albeit with small effect sizes. Further research was needed in populations with more rapid cognitive decline to determine the clinical utility. 

Source: academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiae623/7928940