An example of genetically distinct HIV type 1 variants in cerebrospinal fluid and plasma during suppressive therapy

J Infect Dis. 2014 May 15;209(10):1618-22. doi: 10.1093/infdis/jit805. Epub 2013 Dec 12.


We sequenced the genome of human immunodeficiency virus type 1 (HIV-1) recovered from 70 cerebrospinal fluid (CSF) specimens and 29 plasma samples and corresponding samples obtained before treatment initiation from 17 subjects receiving suppressive therapy. More CSF sequences than plasma sequences were hypermutants. We determined CSF sequences and plasma sequences in specimens obtained from 2 subjects after treatment initiation. In one subject, we found genetically distinct CSF and plasma sequences, indicating that they came from HIV-1 from 2 different compartments, one potentially the central nervous system, during suppressive therapy. In addition, there was little evidence of viral evolution in the CSF during therapy, suggesting that continuous virus replication is not the major cause of viral persistence in the central nervous system.

Keywords: CNS; CSF; HIV; central nervous system; cerebrospinal fluid; compartmentalization; hypermutants; reservoir; suppressive; therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Genetic Variation*
  • Genome, Viral
  • HIV Infections / blood*
  • HIV Infections / cerebrospinal fluid*
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • HIV-1 / classification
  • HIV-1 / genetics*
  • Humans
  • Male
  • RNA, Viral / genetics
  • Viral Load


  • Anti-HIV Agents
  • RNA, Viral