Cerebrospinal fluid viral load in HIV-1-infected patients without antiretroviral treatment: a longitudinal study.
HIV-1 RNA and neopterin levels were observed longitudinally for 20 to 68 months (mean, 37.5 months) in cerebrospinal fluid (CSF) and serum in 15 HIV-1-infected patients not receiving antiretroviral treatment. During the course of infection the HIV-1 RNA levels increased significantly in CSF, from a mean of 3.08 to 3.51 log10 copies RNA/ml (p < .01). A significant positive correlation was found between the CSF levels of HIV-I RNA and neopterin (rs = 0.54; p < .001), which increased from 13.6 to 19.6 nmol/L (p < .01). No significant changes in HIV-1 RNA or neopterin levels were found in serum. We suggest that the increase of CSF viral load with time in HIV-1 infection triggers an intrathecal immune activation reflected by increased CSF levels of neopterin. These results are in accordance with the theory that a chronic immune stimulation within the central nervous system (CNS) is involved in the pathogenesis of neurologic HIV-1 disease.
Gisslén
M
M
Department of Infectious Diseases, Göteborg University, Sweden.
Hagberg
L
L
Fuchs
D
D
Norkrans
G
G
Svennerholm
B
B
D000328:Adult; D018791:CD4 Lymphocyte Count; D002555:Cerebrospinal Fluid / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000134:cerebrospinal fluid / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000276:immunology / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood / Q000134:cerebrospinal fluid; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D019562:Viral Load
D012367:RNA, Viral; D019798:Neopterin