HIV inflammation linked to complex motor skill impairment

Even in its mildest form, HIV-associated neurocognitive impairment can cause problems related to everyday cognitive tasks requiring memory and recall, problem solving and coordinated movement. Now, new research shows that HIV-related inflammation may be to blame for at least a portion of this impairment among people living with HIV maintained in care and on suppressive antiretroviral therapy. These findings underscore the importance of adhering to HIV treatment and taking steps to reduce HIV inflammation.

“If we think about how things have changed over time, we know that people living with HIV were having a lot of problems with complex motor skills early on in the epidemic when there weren’t good HIV treatments,” said David J. Moore, PhD, professor of psychiatry, from UC San Diego’s HIV Neurobehavioral Research Program. “Over time and with better medications, that seemed to kind of resolve. What we really might be looking at now is a kind of chronic accumulation of small inflammatory changes over time that are contributing to the motor impairment we are seeing.”

In a study with 90 adult participants living with HIV and 90 HIV-negative adults, UC San Diego researchers measured inflammatory markers and tested participants on a complex motor skill assessment named the Grooved Pegboard Test.

Used in neuropsychological testing for many years, the Grooved Pegboard Test requires more than fine motor skills, explained Jessica Montoya, PhD, postdoctoral scholar in the Department of Psychiatry at UC San Diego. “It’s a speeded test where you have to keep in mind the instructions, plan for how you will rotate and orient the pegs and manipulate the pegs to fit in the board,” said Montoya. “It’s a task that measures abilities that underlie a lot of everyday behaviors—anything that requires planning and dexterity.”

Participates ranged in age from 36 to 65. Among the participants living with HIV, 60% had an AIDS diagnosis, all were on suppressive antiretroviral therapy and the median duration of HIV infection was 18.5 years.

The group of participants living with HIV had a higher inflammatory “score” (which was a summation of elevated markers of inflammation, including IL-6, TNF-a, MCp-1/CCL2, sCD14 and d-dimer). Participants living with HIV also had a lower complex motor performance score.

On average, people with lower complex motor performance scores had higher levels of inflammation.

Montoya explained that inflammation accounted for about 15% of this effect. “There may be other players here, but inflammation is at least, in part, explaining the relationship between motor impairment and HIV,” she said. “Not only do you want to care for HIV itself, but also for inflammatory processes.”

“The take-away for people living with HIV is that whatever you can do to reduce inflammation is probably a good thing,” said Moore. “If you reduce inflammation, you may have less impairment of this type.”

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Want to know more about HIV-related inflammation—including what you can do about it? Read about what happens in the body with chronic inflammation and get health tips from Joanna Eveland, MD.

Source

Montoya, J. L. and colleagues. Inflammation relates to poorer complex motor performance among adults living with HIV on suppressive antiretroviral therapy. JAIDS, 2019.