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Markers of CNS Injury in Adults Living With HIV With CSF HIV Not Detected vs Detected <20 Copies/mL

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Markers of CNS Injury in Adults Living With HIV With CSF HIV Not Detected vs Detected <20 Copies/mL

Shelli F Farhadian et al. Open Forum Infect Dis.

Abstract

The presence of quantifiable HIV RNA in cerebrospinal fluid (CSF) during antiretroviral therapy (ART) can associate with central nervous system (CNS) pathology, but the significance of RNA detected below the limit of quantification (LOQ) on a standard assay during ART remains unknown. We compared CNS parameters between individuals with CSF RNA detected below the LOQ (20 copies/mL) with those with HIV RNA not detected. Detection of CSF HIV RNA associated with decreased blood-brain barrier integrity and with decreased executive function, but not with CNS immune activation or poorer performance in overall neuropsychological testing.

Keywords: HIV; antiretroviral therapy; blood–brain barrier; viral persistence.

Figures

Figure 1.
Figure 1.
A–H, Cerebrospinal fluid biomarkers in HIV+ participants with CSF HIV RNA not detected or detected below the limit of quantification (<20 copies/mL). Shown are medians and interquartile ranges. Albumin ratio refers to the value of CSF albumin divided by plasma albumin. P values were calculated using the Mann-Whitney test. Abbreviations: CSF, cerebrospinal fluid; WBC, white blood cell count.

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