Human immunodeficiency virus-1 RNA levels in cerebrospinal fluid exhibit a set point in clinically stable patients not receiving antiretroviral therapy.
To characterize, over time, cerebrospinal fluid (CSF) virus-load change in clinically stable patients, human immunodeficiency virus (HIV)-1 RNA levels were measured in serial CSF samples and in plasma samples obtained, during periods of 20 days-6 years, from 17 HIV-infected individuals not receiving antiretroviral treatment. Longitudinal trends were analyzed by linear regression and restricted maximum-likelihood techniques. CSF HIV-1 RNA levels varied within a restricted range (+/-0.5 log(10) copies/mL) around each subject-specific mean. Although 16 of the 17 subjects had CSF slopes not significantly different from zero, slopes that were more positive were associated with lower CD4 counts. In an individual patient, a CSF virus-load change >0.5 log(10) copies/mL may be clinically significant. Furthermore, our data suggest that, if the CSF virus load reflects the size of the reservoir of infected cells in the central nervous system, this reservoir may increase in those individuals with advanced immunosuppression but is stable, over several years, in patients without AIDS.
Department of Neurosciences and HIV Neurobehavioral Research Center, University of California San Diego, San Diego, CA 92103, USA. roellis@ucsd.edu
Ronald J
RJ
Ellis
Meredith E
ME
Childers
Joshua D
JD
Zimmerman
Simon D W
SD
Frost
Reena
R
Deutsch
J Allen
JA
McCutchan
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000235:genetics* / Q000302:isolation & purification*; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000134:cerebrospinal fluid*; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral