Low levels of HIV-1 RNA detected in the cerebrospinal fluid after up to 10 years of suppressive therapy are associated with local immune activation
Low levels of HIV-1 RNA detected in the cerebrospinal fluid after up to 10 years of suppressive therapy are associated with local immune activation
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DOI：
10.1097/qad.0000000000000400
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发表时间：
2014-09-01
期刊：
影响因子：
3.8
通讯作者：
Price, Richard W.
中科院分区：
文献类型：
--
作者：
Dahl, Viktor;Peterson, Julia;Price, Richard W.
目的和设计：尽管联合抗逆转录病毒治疗可将血浆和脑脊液（CSF）中的HIV-1 RNA浓度降低至临床检测限以下，但使用更灵敏的检测方法，血浆中经常可检测到低水平的HIV-1 RNA。我们研究了持续低水平的HIV-1 RNA在CSF中的频率和幅度及其与中枢神经系统（CNS）免疫activation.Methods的关系：CSF和血浆HIV-1 RNA测定使用单拷贝检测的检测限为0.3拷贝/ml的70 CSF和68血浆样本从45个治疗的HIV-1感染的患者小于40拷贝/ml的HIV-1 RNA在这两种液体的标准临床检测。我们还测量了CSF新蝶呤，以评估鞘内免疫激活。结果：70例患者中12例（17%）接受了长达10年的抑制性治疗，68例患者中39例（57%）血浆样本中检测到HIV-1 RNA，CSF中HIV-1 RNA的中位数浓度低于0.3拷贝/ml，血浆中HIV-1 RNA的中位数浓度低于0.3拷贝/ml（P
Objective and design:Though combination antiretroviral therapy reduces the concentration of HIV-1 RNA in both plasma and cerebrospinal fluid (CSF) below the detection limit of clinical assays, low levels of HIV-1 RNA are frequently detectable in plasma using more sensitive assays. We examined the frequency and magnitude of persistent low-level HIV-1 RNA in CSF and its relation to the central nervous system (CNS) immune activation.Methods:CSF and plasma HIV-1 RNA were measured using the single-copy assay with a detection limit of 0.3 copies/ml in 70 CSF and 68 plasma samples from 45 treated HIV-1-infected patients with less than 40 copies/ml of HIV-1 RNA in both fluids by standard clinical assays. We also measured CSF neopterin to assess intrathecal immune activation. Theoretical drug exposure was estimated using the CNS penetration-efficacy score of treatment regimens.Results:CSF HIV-1 RNA was detected in 12 of the 70 CSF samples (17%) taken after up to 10 years of suppressive therapy, compared to 39 of the 68 plasma samples (57%) with a median concentration of less than 0.3 copies/ml in CSF compared to 0.3 copies/ml in plasma (P