Distinct cellular immune properties in cerebrospinal fluid are associated with cognition in HIV-infected individuals initiating antiretroviral therapy

We examined the relationship between CSF immune cells and neurocognition and neuronal damage in HIV+ individuals before and after initiating antiretroviral therapy. Multivariate analysis at baseline indicated that greater CD4+ T cell abundance was associated with better cognition (p = .017), while higher CSF HIV RNA was associated with increased neuronal damage (p = .014). Following 24 weeks of antiretroviral therapy, CD8+ T cells, HLA-DR expressing CD4+ and CD8+ T cells, B cells, NK cells, and non-classical monocyte percentage decreased in CSF. Female gender was negatively associated with cognitive performance over time, as was higher percentage of HLA-DR expressing CD8+ T cells at baseline. [Display omitted] •CSF CD8+ T cells and other immune effector cells decreased after initiating ART.•Activated CSF immune cells remained more abundant in HIV+ individuals after ART.•Greater CSF CD4+ T cell abundance was associated with better cognition at baseline.•Higher CSF HIV RNA was associated with higher neurofilament light chain at baseline.•Cognitive performance over time was associated with female gender and HLA DR+ CD8+.