| Publication Abstract Display | | Type: Published Abstract | | Title: Demonstration of a different "set point" for HIV RNA in CSF, as compared to plasma. | | Authors: Ellis RJ, Letendre SL, Deutsch R, Hsia K, Spector SA, McCutchan JA, and the HNRC Group | | Year: 2000 | | Publication: International Conference on AIDS | | Volume: 13 Issue: Pages: 3181 | | Abstract:Background: Plasma HIV RNA levels are characterized by a subject-specific "set point" (equilibrium over long intervals) in the absence of treatment changes. Set points have not been demonstrated for HIV RNA in cerebrospinal fluid (CSF). Objective: To determine whether HIV RNA in CSF has a set point and if it is different from plasma. Methods: We describe a series of subjects in whom 3 or more serial HIV RNA levels in plasma and CSF each were measured during stable (N = 2) or no (N = 5) antiretroviral therapy. Baseline levels in plasma and CSF were >500 copies/mL for all subjects. Linear regression of HIV RNA vs. time was used to assess change (beta coefficients) and variance (residuals). Results: Forty-eight CSF samples (median 7 per subject) were collected from 7 subjects over 2-38 months. None of the individual CSF HIV RNA slopes was significantly different from zero (all ps > .05). The median CSF slope (+.072 log10 c/mL/ month; range -.072, +.135) indicated a slight trend for increasing CSF HIV RNA levels over time. The median plasma slope was similar (+.026; range -.024, +.168). The median plasma-CSF gradient was 1.23 (-0.78, +2.9) log10 c/mL Ninety percent of CSF residuals (observed minus predicted) were > 0.5 log10 c/mL. Conclusions: These results show that during stable or no antiretroviral treatment, CSF HIV RNA levels maintain a subject-specific "set point," and a stable plasma-CSF gradient during many months of follow-up. A difference in serial measurements of more than 0.5 log10 c/mL probably represents a biologically meaningful change in CSF HIV RNA. |
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