A Determination of Neutral Lipid and Cluster Formation for Screening Neurocognitive Impairment in Human Immunodeficiency Virus Patients

Objectives: Despite combination antiretroviral therapy (cART) introduction, human immunodeficiency virus (HIV) patients have increased risk for neurocognitive impairment (NCI). However, NCI assessment methods in these patients have limitations. Many neurocognitive screening tests, although quicker, identify only the most severe form of impairment and are not suitable for early neurological disorder detection. We previously stated that determination of neutral lipids (NLs) by oil red O (ORO) staining in the cytoplasm of unstimulated peripheral blood mononuclear cells (PBMCs), combined with their tendency to cluster formation (CF), may represent a novel non-invasive approach to detect and monitor neuronal injury in the disease’s early stages. In an attempt to find rapid, feasible tools to screen for NCI in HIV patients, we determined ORO staining and CF in unstimulated PBMCs from HIV-infected adults. Methods: We analyzed demographic and clinical data including ORO and CF markers in 158 HIV-positive subjects receiving regular HIV infection care. Results: We found 45% of HIV patients have higher ORO score (2 to 4) and 46% higher CF score (1-2) compared to age-matched controls. As shown in our previous study, NL accumulation in PBMC cytoplasm appears correlated with cognitive impairment. Also in this HIV patient population, correlation of PBMC NL accumulation with cognitive performance reduction, as highlighted by RBANS, may be indicative of NCI. In addition, according to data given in literature, the prevalence of NCI in HIV patients is high (about 30 -60%). Conclusion: Our data shed light on the fact that as HIV patients have, as indicated by RBANS, lower cognitive performance than controls, and, in addition, that they have higher ORO and CF scores than controls, future studies are needed. Such studies might show that NL/CF screening, together with RBANS, could be useful for the rapid and practical detection of NCI in HIV-infected patients.