title: Undetectable cerebrospinal fluid HIV RNA and beta-2 microglobulin do not indicate inactive AIDS dementia complex in highly active antiretroviral therapy-treated patients.
abstract: OBJECTIVE
  To assess whether nonelevated cerebrospinal fluid (CSF) markers could delineate inactive AIDS dementia complex (ADC) in patients receiving highly active antiretroviral therapy (HAART), using neuropsychologic performance change as an indicator of ADC stability.
  
  
  METHODS
  We used data from the abacavir (ABC) ADC trial (n = 78) and examined the patients' neuropsychologic performance change with the Reliable Change Index according to 3 cutoff groups: (1) CSF viral load (VL) <100 copies/mL, (2) CSF beta-2 microglobulin (beta2m) <2.2 mg/L, and (3) CSF VL and CSF beta2m below cutoffs.
  
  
  RESULTS
  CSF marker cutoff groups did not define neuropsychologic change. Linear regression showed that only CSF VL was a weak predictor of neuropsychologic performance change.
  
  
  CONCLUSIONS
  HAART-treated ADC patients with baseline CSF markers of viral and immunologic inactivity did not necessarily have inactive ADC when followed over 12 weeks. More sensitive CSF markers to judge the activity of ADC are urgently needed, whereas the interpretation of these markers should be considered with caution in HAART-treated ADC patients.
authors: St. Vincent's Hospital Clinical School, University of New South Wales, Darlinghurst, Sydney, Australia. l.cysique@student.unsw.edu.au
authors: Lucette A
authors: LA
authors: Cysique
authors: Bruce J
authors: BJ
authors: Brew
authors: Mark
authors: M
authors: Halman
authors: Jose
authors: J
authors: Catalan
authors: Ned
authors: N
authors: Sacktor
authors: Richard W
authors: RW
authors: Price
authors: Steve
authors: S
authors: Brown
authors: J Hampton
authors: JH
authors: Atkinson
authors: David B
authors: DB
authors: Clifford
authors: David
authors: D
authors: Simpson
authors: Gabriel
authors: G
authors: Torres
authors: Colin
authors: C
authors: Hall
authors: Christopher
authors: C
authors: Power
authors: Karen
authors: K
authors: Marder
authors: Justin C
authors: JC
authors: McArthur
authors: William
authors: W
authors: Symonds
authors: Carmen
authors: C
authors: Romero
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000134:cerebrospinal fluid; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000134:cerebrospinal fluid*; D019562:Viral Load; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D012367:RNA, Viral; D001613:beta 2-Microglobulin