2025 American Academy of Neurology Abstract Website

Daniel De Siqueira Lima¹, Rebeca Silva², Yasmin Lima³, João Pedrosa², Lívia Cavalcanti⁴, Saul Dominici⁵, Elizabeth de Farias⁶, Maria Valverde⁷, Milene Capitanio⁸, Niels Pacheco⁹, Arthur Corvelo¹⁰, Elison Araujo Lima⁶, Anderson Silva¹¹
¹University of California, San Diego, ²Federal University of Paraíba, Brazil, ³Faculty Pernambucana of Health, Brazil, ⁴University of Pernambuco, Brazil, ⁵Federal University of Maranhão, São Luis, Brazil, ⁶Federal University of Roraima, Brazil, ⁷Faculty of Medicine and Health Sciences, Brazil, ⁸Community University of Chapecó Region, Brazil, ⁹Harvard Medical School, Harvard University, USA, ¹⁰Faculty of medicine, University of Grande Rio, Brazil, ¹¹Biochemical, Federal University of The São Francisco Valley, Brazil

Objective:

This study investigates the association between Alzheimer’s disease biomarkers in the cerebrospinal fluid of people living with HIV (PLWH), focusing on patterns of beta-amyloid (A42, A40), and total tau (t-tau) comparing them to those of HIV-negative individuals.

Background:

Combination antiretroviral therapy has prolonged the lifespan of PLWH but has also led to an increased incidence of non-HIV-related dementias, such as Alzheimer’s disease (AD). However, the relationship between AD biomarkers in the cerebrospinal fluid (CSF) of PLWH and HIV-negative individuals remains unclear, especially in older individuals who may experience accelerated aging and heightened susceptibility to neurodegeneration.

Design/Methods:

A systematic review and meta-analysis were conducted, with searches performed in the PubMed, Embase, Web of Science, and Cochrane databases. Primary outcomes included the prevalence of AD biomarker patterns in CSF, comparison of biomarker levels between PLWH and HIV-negative individuals, and the association of these biomarkers with the risk of Alzheimer’s development in PLWH. Heterogeneity was assessed using I² statistics, and sensitivity analyses were conducted to explore the impact of outlier studies

Results:

A total of 1381 studies were identified, of which 4 randomized controlled trials met the inclusion criteria, comprising a sample of 831 patients. The findings indicate significant variations in the CSF biomarker patterns in PLWH compared to HIV-negative controls, particularly in beta-amyloid and total tau levels Odds Ratio was 0.81 risk ratio (RR) with >95%, 0.42-1.56), indicating no statistically significant difference between the groups in terms of the outcome events.

Conclusions:

This study reveals distinct CSF biomarker profiles in PLWH compared to HIV-negative individuals, highlighting the need for further research into the interaction between chronic HIV-related neuroinflammation and the development of neurodegenerative diseases, such as AD.