To the best of our knowledge, this study provides the first evidence that levels of EVs enriched with the bone markers osteocalcin and sclerostin and the kidney marker nephrin are associated with cognitive impairment in PWH on suppressive ART, suggesting that higher abundance of EVs expressing these proteins may serve as novel candidate biomarkers for disease-spanning neurocognitive dysfunction and might lay the foundations of signaling mechanisms between the nervous system and other organs. Here, NPHS1 is linked to Cognitive impairment.