Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection
Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection
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DOI：
10.1097/00002030-200211080-00006
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发表时间：
2002-11-08
期刊：
影响因子：
3.8
通讯作者：
Gisslén, M
中科院分区：
文献类型：
--
作者：
Abdulle, S;Hagberg, L;Gisslén, M
目的：研究抗逆转录病毒联合治疗对 HIV-1 感染鞘内免疫激活的影响。方法：对 30 名无神经症状、未接受治疗的 HIV-1 感染患者在基线时进行腰椎穿刺，并在 4 个月、1 和 2 年后开始使用三种或更多药物进行抗逆转录病毒治疗。测量脑脊液 (CSF) 和血液中新蝶呤、β2-微球蛋白和 HIV-1 RNA 的水平。 结果：所有患者均继续研究直至 4 个月的随访，尽管有 7 名患者在 1 年对照前停止研究，另外 5 名患者在 2 年后在对照前停止研究。脑脊液和血液中的新蝶呤、β2-微球蛋白和 HIV-1 RNA 均显着下降，但尽管 100% 的患者将脑脊液中的 β2-微球蛋白和 HIV-1 RNA 浓度降低至正常水平，但只有 55% 的患者在治疗 2 年后脑脊液新蝶呤浓度达到正常水平。无神经症状的 HIV-1 感染患者中的 β2-微球蛋白。然而，经过两年的有效治疗后，几乎一半的患者脑脊液新蝶呤浓度仍然略有升高，这可能反映了脑组织中持续的低级病毒复制。 (C) 2002 利平科特·威廉姆斯·威尔金斯
Objective: To study the effect of antiretroviral combination treatment on intrathecal immunoactivation in HIV-1 infection.Method: Lumbar punctures were performed at baseline, and after 4 months, 1 and 2 years on 30 neurologically asymptomatic, treatment-naive HIV-1-infected patients started on antiretroviral treatment with three or more drugs. Levels of neopterin, beta2-microglobulin and HIV-1 RNA were measured in cerebrospinal fluid (CSF) and blood.Results: All patients continued the study until the 4-month follow-up, although seven discontinued before the 1-year control, and an additional five discontinued before the control after 2 years. Neopterin, beta2-microglobulin and HIV-1 RNA decreased significantly both in CSF and blood, but although 100% of the patients decreased their CSF concentrations of beta2-microglobulin and HIV-1 RNA to normal levels, only 55% had normal CSF neopterin concentrations after 2 years treatment.Conclusions: in addition to CSF viral load, antiretroviral combination therapy substantially decreases the intrathecal immunoactivation as reflected by CSF neopterin and beta2-microglobulin in neuroasymptomatic HIV-1-infected patients. However, almost half of the patients still have slightly increased CSF neopterin concentrations after 2 years of effective treatment, which might reflect an ongoing low-grade viral replication in brain tissue. (C) 2002 Lippincott Williams Wilkins