Plasma Cytokine Biomarker Cutoff Values for HIV-Associated Neurocognitive Impairment in Adults

被引:0
|
作者
Ruhanya, Vurayai [1 ,2 ]
Jacobs, Graeme B. [1 ]
Paul, Robert H. [3 ]
Joska, John A. [4 ]
Seedat, Soraya [5 ]
Nyandoro, George [2 ]
Engelbrecht, Susan [1 ]
Glashoff, Richard H. [6 ,7 ]
机构
[1] Stellenbosch Univ, Div Med Virol, ZA-7500 Cape Town, South Africa
[2] Univ Zimbabwe, Dept Med Microbiol, Harare, Zimbabwe
[3] Univ Missouri St Louis, Dept Psychol & Behav Neurosci, Univ Blvd, St Louis, MO USA
[4] Univ Cape Town, Dept Psychiat & Mental Hlth, MRC Unit Anxiety & Stress Disorders, Cape Town, South Africa
[5] Univ Stellenbosch, Dept Psychiat, MRC Unit Anxiety & Stress Disorders, Cape Town, South Africa
[6] Stellenbosch Univ, Div Med Microbiol, Cape Town, South Africa
[7] Tygerberg Business Unity, Natl Hlth Lab Serv NHLS, Cape Town, South Africa
基金
新加坡国家研究基金会; 英国医学研究理事会;
关键词
cytokine biomarkers; ROC; cut-off; diagnostic accuracy; HAND; DEFICIT SCORES; DNA; DISORDERS; COGNITION; ACCURACY;
D O I
10.1089/vim.2021.0047
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Diagnosing HIV-associated neurocognitive impairment in most high-burden, but resource-constrained, settings is difficult due to the unavailability of specialist neurologists and neuropsychologists in primary health care centers. New tests that are easy to perform, based on virological and host immune response biomarkers, may be valuable in the diagnosis of HIV-associated neurocognitive disorder. The receiver operator characteristic curve analysis was used to investigate the diagnostic accuracy of threshold/cutoff concentrations for the peripheral lymphocyte proviral load and plasma biomarkers as diagnostic candidates for neurocognitive impairment in 133 HIV-infected individuals, using global deficit scores as the clinical gold standard. Forty-five (33.83%) of the participants had HIV-associated neurocognitive impairment, with 17.29% being mildly impaired and 16.54% moderately impaired. IL-2 had the best performance as a diagnostic tool for neurocognitive impairment with sensitivity of 67% and specificity of 52%, while the lowest performance was IL-6 with 65% sensitivity and 39% specificity. MIP-1 alpha had the highest precision for the cutoff value, as indicated by the narrow 95% confidence interval (CI) (2.23-3.27), followed by IL-2 with 95% CI (3.02-5.12). RANTES had least precision, as shown by the widest 95% CI (135-9,487.61). For clinical markers of HIV diagnosis and monitoring, the lymphocyte proviral load cutoff value of 145 genome copies/million cells had the highest accuracy with 60% sensitivity and 51% specificity. The plasma viral load had an imperfect balance of 46% sensitivity and 78% specificity. The study demonstrated low to medium diagnostic accuracy of plasma cytokine biomarker cutoff values for defining neurocognitive impairment in people living with HIV.
引用
收藏
页码:689 / 696
页数:8
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