Asymptomatic Cerebrospinal Fluid HIV-1 Viral Blips and Viral Escape During Antiretroviral Therapy: A Longitudinal Study.
We examined longitudinal cerebrospinal fluid (CSF) samples (median, 5 samples/patients; interquartile range [IQR], 3-8 samples/patient) in 75 neurologically asymptomatic human immunodeficiency virus (HIV)-infected patients receiving antiretroviral therapy. Twenty-seven patients (36%) had ≥1 CSF HIV RNA load of >20 copies/mL (23% had ≥1 load of >50 copies/mL), with a median HIV RNA load of 50 copies/mL (IQR, 32-77 copies/mL). In plasma, 42 subjects (52%) and 22 subjects (29%) had an HIV RNA load of >20 and >50 copies/mL, respectively. Two subjects had an increasing virus load in consecutive CSF samples, representing possible CSF escape. Of 418 samples, 9% had a CSF HIV RNA load of >20 copies/mL (5% had a load of >50 copies/mL) and 19% had a plasma HIV RNA load of >20 copies/mL (8% had a load of >50 copies/mL). A CSF-associated virus load of >20 copies/mL was associated with higher CSF level of neopterin. In conclusion, CSF escape was rare, and increased CSF HIV RNA loads usually represented CSF virus load blips.
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg.
Arvid
A
Edén
Mathematical Sciences, Chalmers University of Technology.
Staffan
S
Nilsson
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg.
Lars
L
Hagberg
Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Austria.
Dietmar
D
Fuchs
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.|Department of Molecular Neuroscience, Institute of Neurology, University College London, United Kingdom.
Henrik
H
Zetterberg
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg.
Bo
B
Svennerholm
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg.
Magnus
M
Gisslén
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002555:Cerebrospinal Fluid / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000134:cerebrospinal fluid; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult
D044966:Anti-Retroviral Agents; D012367:RNA, Viral
CSF blip; CSF escape; HIV-1; NFL; cerebrospinal fluid; neopterin; neurofilament; viral blip