Plasma levels of soluble CD14 and tumor necrosis factor-alpha type II receptor correlate with cognitive dysfunction during human immunodeficiency virus type 1 infection

The relationship between monocyte immune responses and cognitive impairment during progressive human immunodeficiency virus type 1 (HIV-1) infection w as investigated in 28 subjects receiving highly active antiretroviral thera py. The mean +/- SEM CD4(+) T lymphocyte count and virus load for all patie nts were 237 +/- 41 cells/mm(3) and 77,091 +/- 195,372 HIV-1 RNA copies/mL, respectively. Levels of soluble tumor necrosis factor-alpha type II recept or (sTNF-RII) and soluble CD14 (sCD14) were measured in plasma by ELISA and were correlated with results from neuropsychological, magnetic resonance i maging, and magnetic resonance spectroscopy tests. Plasma sCD14 and sTNF-RI I levels were elevated in subjects with cognitive impairment and in those w ith brain atrophy. Furthermore, both factors were correlated with spectrosc opic choline: creatine ratios. These findings support the idea that periphe ral immune responses are linked to cognitive dysfunction during advanced HI V-1 disease.