title: Cerebrospinal fluid viral load and neopterin in HIV-positive patients with undetectable viraemia.
abstract: BACKGROUND
  Cerebrospinal fluid (CSF) HIV RNA is commonly used as a marker of compartmental antiviral activity in HIV-positive patients. Undetectable CSF HIV RNA levels have been associated with low CSF neopterin levels and better neurocognitive performances. The aim of this study was to analyse the prevalence and predictors of non-detectable CSF HIV RNA using a commercial assay.
  
  
  METHODS
  In adult HIV-positive HAART-treated patients with confirmed plasma HIV RNA <50 copies/ml, CSF HIV RNA (with Roche Amplicor Assay) and neopterin were measured.
  
  
  RESULTS
  112 adult patients were included. Plasma and CSF HIV RNA were non-detectable (target not detected [TND]) in 29 (25.9%) and 36 (32.1%) patients, respectively. CSF TND was observed more frequently in patients with plasma TND (P=0.005, OR=3.87). CSF neopterin levels were associated with age (rho =0.333, P=0.002) and current (rho= -0.272, P=0.015) and nadir (rho =-0.240, P=0.038) CD4+T-lymphocytes; the lowest CSF neopterin concentration was observed in patients with CSF TND versus other viral load strata (0.62 mg/dl versus 0.78 mg/dl; P=0.048).
  
  
  CONCLUSIONS
  Efficaciously treated HIV-positive patients with detectable plasma HIV RNA might imperfectly control CSF viral replication. Prospective studies addressing the management and neurocognitive consequences of CSF low-level viraemia are warranted.
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Motta
authors.affiliation: Laboratory of Microbiology and Molecular Biology, Ospedale Amedeo di Savoia, ASL TO2, Torino, Italy.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Allice
authors.affiliation: Laboratory of Immunology, Ospedale Maria Vittoria, ASL TO2, Torino, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Romito
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Micol
authors.initials: M
authors.lastname: Ferrara
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ecclesia
authors.affiliation: Unit of Neurology, Ospedale Maria Vittoria, ASL TO2, Torino, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Imperiale
authors.affiliation: Laboratory of Microbiology and Molecular Biology, Ospedale Amedeo di Savoia, ASL TO2, Torino, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Ghisetti
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Perri
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonora
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Calcagno
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D002555:Cerebrospinal Fluid / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000134:cerebrospinal fluid*; D012367:RNA, Viral; D019562:Viral Load; D014766:Viremia
chemical_list: D015415:Biomarkers; D012367:RNA, Viral; D019798:Neopterin