Plasma anti-CD4 IgG is associated with brain abnormalities in people with HIV on antiretroviral therapy

Anti-CD4 IgG autoantibodies have been implicated in CD4 + T cell reconstitution failure, leaving people with HIV (PWH) at heightened risk of HIV-associated comorbidities, such as neurocognitive impairment. Seventeen PWH on stable anti-retroviral therapy (ART) and 10 HIV seronegative controls had plasma anti-CD4 IgG antibodies measured by enzyme-linked immunosorbent assay. Neuropsychological (NP) tests assessed cognitive performance, and brain volumes were measured by structural magnetic resonance imaging. Anti-CD4 IgG levels were elevated ( p = 0.04) in PWH compared with controls. Anti-CD4 IgG correlated with global NP z -scores (rho = − 0.51, p = 0.04). A relationship was observed between anti-CD4 IgG and putamen ( β = − 0.39, p = 0.02), pallidum ( β = − 0.38, p = 0.03), and amygdala ( β = − 0.42, p = 0.05) regional brain volumes. The results of this study suggest the existence of an antibody-mediated relationship with neurocognitive impairment and brain abnormalities in an HIV-infected population.