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J Acquir Immune Defic Syndr. 2017 Mar 1;74(3):243-249. doi: 10.1097/QAI.0000000000001235.

Higher Cystatin C Levels Are Associated With Neurocognitive Impairment in Older HIV+ Adults.

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*Department of School of Medicine, John A. Burns School of Medicine, University of Hawaii Honolulu, HI; Departments of †Psychiatry; ‡Neurosciences, University of California, San Diego, San Diego, CA; §Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA; and ‖Department of Medicine, University of California, San Diego, San Diego, CA.



The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI).


Participants included 124 (HIV+ n = 77; HIV- n = 47) older adults (age ≥ 50 years) examined at the University of California, San Diego HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI.


The HIV+ group had significantly higher cystatin C concentrations than the HIV- group (d = 0.79 P < 0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d = 0.42, P = 0.055), particularly among participants taking tenofovir (d = 0.78, P = 0.004). A receiver-operator characteristic curve identified that cystatin C levels ≥0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; P = 0.03).


Our results confirm that HIV+ older adults have higher cystatin C than HIV- older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.

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