The Association of Immune Markers with Cognitive Performance in South African HIV-Positive Patients

  • Monray E. WilliamsEmail author
  • Jonathan C. Ipser
  • Dan J. Stein
  • John A. Joska
  • Petrus J. W. Naudé


Dysregulated expression of neuro-immune markers has previously been linked to HIV-associated neurocognitive impairment. We undertook an exploratory approach in a HIV clade-C cohort, investigating the association between eight immune markers and neurocognitive performance in 99 HIV+ and 51 HIV- participants. Markers were selected on preliminary and putative evidence of their link to key neuro-immune functions. Cognitive performance was established using a battery of tests sensitive to HIV-associated neurocognitive impairment, with domain-based scores utilized in analysis. The markers Thymidine phosphorylase (TYMP) and Neutrophil gelatinase-associated lipocalin (NGAL) were significantly higher while Matrix Metalloproteinase (MMP)9 was significantly lower in HIV+ participants. Our results further showed that in the HIV+ group, worse psychomotor processing speed was associated with higher TYMP and NGAL levels and worse motor function was associated with higher NGAL levels. Future studies should explore the underlying mechanisms of these markers in HIV-associated neurocognitive impairment.

Graphical Abstract

The association of peripheral immune markers with neurocognitive performance in South African HIV-positive patients.


HIV HIV-associated neurocognitive impairments HAND Cognition Neuroinflammation and cytokines 



The authors would like to acknowledge all funding contributors. MW was funded by the National Research Foundation (NRF) and Poliomyelitis Research Foundation (PRF). PN was funded by the Harry Crossley Foundation and South African Society for Biological Psychiatry.

Compliance with Ethical Standards

Conflict of Interest


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychiatry and Mental Health and Neuroscience Institute, Brain Behaviour Unit, Groote Schuur HospitalUniversity of Cape TownCape TownSouth Africa
  2. 2.SU/UCT MRC Unit on Risk and Resilience in Mental Disorders and Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  3. 3.Division of Neuropsychiatry, Department of Psychiatry and Mental Health, Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa

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