T-lymphocyte activation markers in patients with HIV-1-associated neurocognitive disorder

Despite immune-reconstitution, after TARc HIV-positive patients, neurocognitive disorders related to HIV-1 (HAND) have been observed in these patients. The diagnosis occurs, in most cases, in the advanced stage. The objective of this study is to quantify activation markers (CD25, CD38, CD69, and HLA-DR) in the blood of patients with chronic HIV-1 infection and relate to HAND and premature senescence. The level of activation markers was quantified in the blood of 10 HIV-positive patients with HAND, 10 cases without HAND undergoing regular follow-up at the Secondary Immunodeficiency Clinic (ADEE3002) at the Hospital of Clinics of the Medical School of São Paulo, and 10 healthy seronegative volunteers using the flow cytometry method. Subsequently, the analysis was performed using the FlowJo™ v10.6.1 program and GraphPad Prism 8.3.0. In addition to T CD4⁺ cells, T CD4⁺ bright/CD8⁺ dim and T CD4⁺/CD8⁺/CD45RA⁻/CD27 cells, a specific HIV-1 phenotype, also proved to be relevant to differentiate patients with HAND. Between the activation marker, CD38 in T CD4⁺ and T CD4⁺/CD8⁺/CD45RA⁻/CD27⁺ cells and the activation marker HLA-DR in T CD8⁺/CD45RA⁻/CD27⁺ managed to differentiate our HAND group. Importantly, only non-stimulated peripheral blood mononuclear cells (PBMCs) were used in this study. A combination of activation and senescence markers CD38 and HLA-DR and subgroups of T lymphocytes can be used to indicate seropositive patients who are progressing to a HAND condition. Thus, it can contribute to an early diagnosis and opportunity for possible reversal of dementia with alternative treatments, with high penetration in the blood–brain barrier.