title: Pleocytosis is associated with disruption of HIV compartmentalization between blood and cerebral spinal fluid viral populations.
abstract: BACKGROUND
  We hypothesized that pleocytosis, which is a marker of central nervous system (CNS) inflammation, would result in viral genetic equilibration or de-compartmentalization between HIV populations in the blood and cerebrospinal fluid (CSF), suggesting viral trafficking.
  
  
  METHODS
  Study subjects, who started or interrupted their antiretroviral treatment, had viral loads measured and clonal viral env sequences generated from HIV RNA extracted from paired blood and CSF samples. White blood counts in CSF were also measured at each timepoint. Degree of inter-compartment segregation was calculated by posterior probability using linear discriminant analysis and multidimensional scaling. Co-receptor usage was determined using a trained support vector machine.
  
  
  RESULTS
  Pleocytosis was strongly associated with disruption of viral compartmentalization.
  
  
  CONCLUSIONS
  Inflammation in the CNS, marked by pleocytosis, allows HIV populations to mix between blood and CSF, which may increase the overall viral genetic diversity within the CSF.
authors.affiliation: University of California San Diego, La Jolla, 92093, USA. davey@ucsd.edu
authors.forename: Davey M
authors.initials: DM
authors.lastname: Smith
authors.forename: Selene
authors.initials: S
authors.lastname: Zárate
authors.forename: Hai
authors.initials: H
authors.lastname: Shao
authors.forename: Satish K
authors.initials: SK
authors.lastname: Pillai
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Wong
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Richman
authors.forename: Simon D W
authors.initials: SD
authors.lastname: Frost
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D014644:Genetic Variation; D015658:HIV Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D007964:Leukocytosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000235:genetics; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D019713:Receptors, CCR5 / Q000378:metabolism; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D019713:Receptors, CCR5