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Publication Abstract Display | Type: Published Abstract | Title: Neurovirological correlation with HIV-associated neurocognitive disorders and encephalitis in a HAART era cohort. | Authors: Gelman B, Lisinicchia J, Morgello S, Maslia E, Commins D, Grant I, Singer E, Sherman S, Gensler G, Soukup V, and NNTC | Year: 2013 | Publication: 20th Conference on Retroviruses and Opportunistic Infections | Volume: Issue: Pages: | Abstract:Objective: Replicating HIV-1 in the brain is present in HIV
encephalitis (HIVE) and microglial nodule encephalitis (MGNE) and
is putatively linked with HIV-associated neurocognitive disorders
(HAND). A cliniconeurovirological correlation was conducted to
elucidate the relationship between brain viral load and clinical
phenotype.
Subjects and assays: HIV gag/pol RNA and DNA copies were
quantified with reverse transcriptase-polymerase chain reaction or
polymerase chain reaction in 148 HAART-era brain specimens.
Comparison with HAND, HIVE, and MGNE and correlation with
neuropsychological (NP) test scores were done using one-way
ANOVA with Tukey-Kramer and Spearman tests, respectively.
Results: Brain HIV RNA was higher in subjects with HAND plus
HIVE versus without HAND (delta = 2.48 log10 units, n = 27 versus
36, P , 0.001). In HAND without HIVE or MGNE, brain HIV RNA
was not significantly different versus without HAND (P = 0.314).
Worse NP scores correlated significantly with higher HIV RNA and
interferon responses in brain specimens (P , 0.001) but not with
HIV RNA levels in premortem blood plasma (n = 114) or cerebrospinal
fluid (n = 104). In subjects with MGNE, brain HIV RNA was
slightly higher versus without MGNE (P , 0.01) and much lower
versus with HIVE (P , 0.001).
Conclusions: Brain HIV RNA and to a lesser extent HIV DNA are
correlated with worse NP performance in the 6 months before death.
Linkage occurs primarily in patients with HIVE and MGNE, and these
patients could obtain added NP improvement by further reducing brain
HIV while on HAART. Patients not in those groups are less certain to
obtain added NP benefit. |
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