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


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.


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.


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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    1. Calcagno A, Atzori C, Romito A, et al. Blood brain barrier impairment is associated with cerebrospinal fluid markers of neuronal damage in HIV-positive patients. J Neurovirol 2016; 22:88–92. - PubMed
    1. Heaton RK, Clifford DB, Franklin DR Jr, et al. ; CHARTER Group HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER study. Neurology 2010; 75:2087–96. - PMC - PubMed
    1. Spudich S, Gisslen M, Hagberg L, et al. Central nervous system immune activation characterizes primary human immunodeficiency virus 1 infection even in participants with minimal cerebrospinal fluid viral burden. J Infect Dis 2011; 204:753–60. - PMC - PubMed
    1. Jessen Krut J, Mellberg T, Price RW, et al. Biomarker evidence of axonal injury in neuroasymptomatic HIV-1 patients. PLoS One 2014; 9:e88591. - PMC - PubMed
    1. Rahimy E, Li FY, Hagberg L, et al. Blood-brain barrier disruption is initiated during primary HIV infection and not rapidly altered by antiretroviral therapy. J Infect Dis 2017; 215:1132–40. - PMC - PubMed