Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy

Background Gut damage allows translocation of bacterial lipopolysaccharide (LPS) and fungal β-D-glucan (BDG) into the blood.

This microbial translocation contributes to systemic inflammation and risk of non-AIDS comorbidities in people living with HIV, including those receiving antiretroviral therapy (ART).

We assessed whether markers of gut damage and microbial translocation were associated with cognition in ART-treated PLWH.

Methods Eighty ART-treated men living with HIV from the Positive Brain Health Now Canadian cohort were included.

Brief cognitive ability measure (B-CAM) and 20-item patient deficit questionnaire (PDQ) were administered to all participants.

Three groups were selected based on their B-CAM levels.

We excluded participants who received proton pump inhibitors or antiacids in the past 3 months.

Cannabis users were also excluded.

Plasma levels of intestinal fatty acid binding protein (I-FABP), regenerating islet-derived protein 3 α (REG3α), and lipopolysaccharides (LPS = were quantified by ELISA, while 1–3-β-D-glucan BDG) levels were assessed using the Fungitell assay.

Univariable, multivariable, and splines analyses were performed.

Results Plasma levels of I-FABP, REG3α, LPS and BDG were not different between groups of low, intermediate and high B-CAM levels.

However, LPS and REG3α levels were higher in participants with PDQ higher than the median.

Multivariable analyses showed that LPS association with PDQ, but not B-CAM, was independent of age and level of education.

I-FABP, REG3α, and BDG levels were not associated with B-CAM nor PDQ levels in multivariable analyses.

Conclusion In this well characterized cohort of ART-treated men living with HIV, bacterial but not fungal translocation was associated with presence of cognitive difficulties.

These results need replication in larger samples.