Increased blood-brain barrier permeability in neuro-asymptomatic HIV-1-infected individuals—correlation with cerebrospinal fluid HIV-1 RNA and neopterin levels

• Published in: Journal of neurovirology Vol. 7; no. 6; pp. 542 - 547
• Main Author: M Andersson, L Hagberg, D Fuchs, B Svennerholm, M Gisslén, L
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 01.12.2001
• Subjects: Adolescent; Adult; Aged; Anti-HIV Agents - therapeutic use; Blood-Brain Barrier; Female; HIV Infections - cerebrospinal fluid; HIV Infections - drug therapy; HIV Infections - physiopathology; HIV-1 - genetics; Human immunodeficiency virus 1; Humans; Male; Middle Aged; neopterin; Neopterin - blood; Neopterin - cerebrospinal fluid; RNA, Viral - blood; RNA, Viral - cerebrospinal fluid; Serum Albumin - cerebrospinal fluid
• ISSN: 1355-0284; 1538-2443
• DOI: 10.1080/135502801753248123

The objective of this study was to assess the frequency of blood-brain barrier (BBB) impairment, as measured by the albumin ratio, in neuro-asymptomatic HIV-1-infected individuals without antiretroviral treatment and the correlation between BBB disruption and intrathecal immune activation and HIV-1 RNA levels. Serum and cerebrospinal fluid (CSF) albumin, neopterin, and HIV-1 RNA levels were analysed in 110 neuro-asymptomatic HIV-1-infected individuals at different stages of disease; 63 classified as CDC A, 25 as CDC B, and 22 as CDC C. Increased BBB permeability was found in 17 of 110 (15%) of HIV-1-infected individuals. This proportion was sustained throughout the CDC stages. The albumin ratio was correlated with the CSF neopterin levels (r s = 0.36, P < 0.001), the serum neopterin levels (r s = 0.37, P < 0.001), and the CSF HIV-1 RNA levels (r s = 0.26, P < 0.01), but not with the plasma HIV-1 RNA levels. The correlations between the albumin ratio and the CSF and serum neopterin concentrations and the CSF HIV-1 RNA levels indicate that immune activation and, possibly, intrathecal HIV-1 virus replication are important factors associated with increased BBB permeability in HIV-1 infection.