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CSF concentrations of soluble TREM2 as a marker of microglial activation in HIV-1 infection

Journal article
Authors Magnus Gisslén
Amanda Heslegrave
E. Veleva
A. Yilmaz
L. M. Andersson
L. Hagberg
S. Spudich
D. Fuchs
R. W. Price
Henrik Zetterberg
Published in Neurology-Neuroimmunology & Neuroinflammation
Volume 6
Issue 1
ISSN 2332-7812
Publication year 2019
Published at Institute of Biomedicine, Department of Infectious Medicine
Language en
Keywords cerebrospinal-fluid neopterin, multiple-sclerosis, initiation, biomarker, disease, protein, strem2, Neurosciences & Neurology, ice rw, 1988, journal of infectious diseases, v158, p1079
Subject categories Infectious Medicine, Neurosciences


Objective To explore changes in CSF sTREM2 concentrations in the evolving course of HIV-1 infection. In this retrospective cross-sectional study, we measured concentrations of the macrophage/ microglial activation marker sTREM2 in CSF samples from 121 HIV-1-infected adults and 11 HIV-negative controls and examined their correlations with other CSF and blood biomarkers of infection, inflammation, and neuronal injury. CSF sTREM2 increased with systemic and CNS HIV-1 disease severity, with the highest levels found in patients with HIV-associated dementia (HAD). In untreated HIV-1-infected patients without an HAD diagnosis, levels of CSF sTREM2 increased with decreasing CD4(+) T-cell counts. CSF concentrations of both sTREM2 and the neuronal injury marker neurofilament light protein (NFL) were significantly associated with age. CSF sTREM2 levels were also independently correlated with CSF NFL. Notably, this association was also observed in HIV-negative controls with normal CSF NFL. HIV-infected patients on suppressive antiretroviral treatment had CSF sTREM2 levels comparable to healthy controls. Elevations in CSF sTREM2 levels, an indicator of macrophage/microglial activation, are a common feature of untreated HIV-1 infection that increases with CD4(+) T-cell loss and reaches highest levels in HAD. The strong and independent association between CSF sTREM2 and CSF NFL suggests a linkage between microglial activation and neuronal injury in HIV-1 infection. CSF sTREM2 has the potential of being a useful biomarker of innate CNS immune activation in different stages of untreated and treated HIV-1 infection.

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