Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 214, Issue 12, Pages 1822-1825Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiw454
Keywords
HIV-1; cerebrospinal fluid; CSF escape; CSF blip; viral blip; neopterin; neurofilament; NFL
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Funding
- University of Gothenburg [ALFGBG-11067]
- Swedish Research Council [2007-7092]
- Molecular Infection Medicine Sweden
- Knut and Alice Wallenberg Foundation
- Swedish Physicians Against AIDS Foundation
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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 > 50copies/mL), with a median HIV RNA load of 50 copies/mL (IQR, 3277 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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