期刊
AIDS
卷 31, 期 2, 页码 247-252出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000001314
关键词
acute HIV; central nervous system; cerebrospinal fluid; combination antiretroviral therapy; HIV; microglia; microglial activation; neuroinflammation; neuronal injury; neuropathogenesis; YKL-40
资金
- National Institutes of Health [R01MH095613, R01NS084911, R01BS061696]
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc [W81XWH-07-2-0067]
- U.S. Department of Defense (DoD) [W81XWH-07-2-0067]
Objective: To characterize cerebrospinal fluid (CSF) YKL-40, a unique biomarker that reflects activation of microglial cells, in acute (AHI) and chronic HIV-1 infection (CHI) and to determine the effect of treatment initiation on levels of this marker. Design: A cross-sectional study of two groups of HIV-infected participants at baseline and follow-up timepoints. Methods: AHI (n = 33) and CHI (n = 34) participants underwent CSF and blood sampling before treatment initiation with combination antiretroviral therapy (cART) and at follow-up on cART in a subset of these individuals [6 months in AHI participants (n = 24), 1 year in CHI participants (n = 10)]. Measured parameters were analyzed at each timepoint. Analyses employed Mann-Whitney tests and Spearman correlations. Results: Baseline median YKL-40 was higher in CHI than AHI (96844 versus 80754 ng/l; P = 0.011). Elevations in the CHI group relative to the AHI group persisted at follow-up despite treatment (87414 versus 66130 ng/l; P = 0.003). In untreated CHI, YKL-40 correlated with neopterin (r = 0.51, P = 0.0025), chemokine (CXC-motif) ligand-10 (r = 0.44, P = 0.011), and neurofilament light chain (r = 0.56, P = 0.0008) in CSF. Conclusions: This study is the first to describe the dynamics of CSF YKL-40 in two groups of HIV-infected individuals before and after cART and demonstrates the value of this marker in understanding HIV neuropathogenesis. The results suggest the utility of further exploring the prognostic value of YKL-40, particularly in individuals with early HIV infection or those initiating treatment during CHI. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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