MGB Division of Infectious Diseases (@mgb-id.bsky.social)

Quantifying brain-age gap in people with HIV on... : AIDS ls in the general population. Design: Secondary analysis of the multicenter observational cohort study (ACTG HAILO) involving older, cognitively unimpaired PWH on antiretroviral therapy (ART). Methods: Plasma NfL concentrations were quantified using the Quanterix® Simoa assay in 340 PWH aged ≥45 years. Values were compared with two age-stratified reference standards from cognitively unimpaired general-population controls. The brain-age gap was estimated using a generalized logistic model with repeated measures so that 5% of observed NfL concentrations in PWH would exceed the reference upper 95th percentile for the imputed age. Results: Median plasma NfL concentration was 10.1 pg/mL (IQR: 7.4–13.5). Using Simrén et al. standards, 24.1% (95% CI: 19.8–29.0) of observed values exceeded the age-specific upper 95th percentile, and 10.0% (95% CI: 7.2–13.7) using Bornhorst et al. standards. Model-based results suggested brain age was 11.0 years (95% CI: 9.1–13.7) or 6.4 years (95% CI: 5.1–8.5) higher than chronological age, depending on the standard. The estimated brain-age gap was significantly greater in individuals with subsequent cognitive decline than in those without (Simrén: 13.0 vs. 8.4 years; Bornhorst: 7.6 vs. 5.0 years). Conclusion: Plasma NfL reflects a substantial brain-age gap in cognitively unimpaired PWH on ART, supporting evidence of advanced aging. The brain-age gap was higher in PWH with subsequent cognitive decline. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc.... https://journals.lww.com/aidsonline/abstract/9900/quantifying_brain_age_gap_in_people_with_hiv_on.899.aspx