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...

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Published inThe Journal of infectious diseases Vol. 214; no. 12; pp. 1822 - 1825
Main Authors Edén, Arvid, Nilsson, Staffan, Hagberg, Lars, Fuchs, Dietmar, Zetterberg, Henrik, Svennerholm, Bo, Gisslén, Magnus
Format Journal Article
LanguageEnglish
Published United States Oxford University Press 15.12.2016
Subjects
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Retroviral Agents - therapeutic use
Cerebrospinal Fluid - virology
Female
HIV Infections - drug therapy
HIV Infections - virology
HIV-1 - isolation & purification
HIV/AIDS
Humans
Infectious Medicine
Infektionsmedicin
Longitudinal Studies
Male
Middle Aged
Neurosciences
Neurovetenskaper
Retrospective Studies
RNA, Viral - cerebrospinal fluid
Viral Load
Young Adult
HIV-1
CSF blip
CSF escape
NFL
neurofilament
cerebrospinal fluid
neopterin
viral blip
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Summary: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.
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ISSN:0022-1899
1537-6613
1537-6613
DOI:10.1093/infdis/jiw454