| Publication Abstract Display | | Type: Published Abstract | | Title: The relationship between levels of CD4+ counts and HIV-1 RNA in CSF and plasma in 900 samples. | | Authors: Letendre S, Ellis R, Grant I, McCutchan J, and the HNRC Group | | Year: 2001 | | Publication: 8th Conference on Retroviruses and Opportunistic Infections | | Volume: Issue: Pages: 616 | | Abstract:Background: Elevated HIV-1 RNA levels in CSF both are associated with and predict the development of HIV-associated cognitive syndromes. Despite this possible clinical utility, medical providers rarely obtain CSF for measurement of viral load. Data from large cohort studies may provide estimates of the risk of elevated CSF HIV RNA levels based on measurements of plasma RNA and CD4 counts. Methods: The HNRC database was queried to find all subject-visits with values for CD4 counts, HIV RNA levels in plasma and CSF, CSF WBCs, and ARV usage. 900 visits from 464 subjects were identified. Quartiles were defined, and a series of 3-D histograms was constructed to describe the probability of finding a CSF RNA level > 400 c/ml under different conditions. Results: The series of histograms demonstrated that CSF RNA levels > 400 c/ml were more likely in those with higher plasma RNA levels for the group as a whole. However, CSF pleocytosis and the use of antiretrovirals (ARVs) strongly modified these relationships; those with pleocytosis were more likely to have CSF RNA levels > 400 and those taking ARVs, including protease inhibitor-containing regimens, were less. [table: see text] Conclusions: Easily obtainable clinical data can predict the probability of CSF HIV RNA levels greater than 400. |
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