JAIDS Journal of Acquired Immune Deficiency Syndromes. 79(1):108–116, SEPTEMBER 1, 2018
DOI: 10.1097/QAI.0000000000001752
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PMID: 29781885
Issn Print: 1525-4135
Publication Date: September 1, 2018
Improved Cognitive Performance and Reduced Monocyte Activation in Virally Suppressed Chronic HIV After Dual CCR2 and CCR5 Antagonism
Michelle D'Antoni;Robert Paul;Brooks Mitchell;Lindsay Kohorn;Laurent Fischer;Eric Lefebvre;Star Seyedkazemi;Beau Nakamoto;Maegen Walker;Kalpana Kallianpur;Debra Ogata-Arakaki;Lishomwa Ndhlovu;Cecilia Shikuma;
+ Author Information
*Hawai'i Center for AIDS;†Department of Tropical Medicine, Medical Microbiology & Pharmacology, University of Hawai'i, Honolulu, HI;‡University of Missouri–St. Louis, St-Louis, MO;§Allergan, South San Francisco, CA;║Department of Neurology, Straub Medical Center, Honolulu, HI; and¶Department of Psychology, University of Hawai'i at Manoa, Honolulu, HI.
Abstract
To evaluate changes in neuropsychological (NP) performance and in plasma and cell surface markers of peripheral monocyte activation/migration after treatment with cenicriviroc (CVC), a dual C-C chemokine receptor type 2 (CCR2) and type 5 (CCR5) antagonist, in treatment-experienced, HIV-infected individuals.Single-arm, 24-week, open-label clinical trial.HIV-infected individuals on antiretroviral therapy ≥1 year with plasma HIV RNA ≤50 copies per milliliter and below-normal cognitive performance [defined as age-, sex-, and education-adjusted NP performance (NPZ) <−0.5 in a single cognitive domain or in global performance] were enrolled. Changes over 24 weeks were assessed for global and domain-specific NPZ scores, plasma markers of monocyte/macrophage activation [neopterin, soluble (s)CD14, and sCD163] quantified by ELISA, and CCR2 and CCR5 expression on monocytes, and T cells measured by flow cytometry.Seventeen of 20 enrolled participants completed the study. Improvements over 24 weeks were observed in global NPZ [median change (Δ) = 0.24; P = 0.008], and in cognitive domains of attention (Δ0.23; P = 0.011) and working memory (Δ0.44; P = 0.017). Plasma levels of sCD163, sCD14 and neopterin decreased significantly (P's < 0.01). CCR2 and CCR5 monocyte expression remained unchanged; however, CCR5 levels on CD4+ and CD8+ T cells and CCR2 expression on CD4+ T cells increased (P's < 0.01).CVC given over 24 weeks was associated with improved NP test performance and decreased plasma markers of monocyte immune activation in virally suppressed, HIV-infected participants. These data potentially link changes in monocyte activation to cognitive performance. Further study of CVC for HIV cognitive impairment in a randomized controlled study is warranted.
