Publication Abstract Display
Type: Published Manuscript
Title: Prevalence and correlates of persistent HIV-1 RNA in cerebrospinal fluid during antiretroviral therapy.
Authors: Anderson AM, Munoz-Moreno JA, McClernon D, Ellis RJ, Cookson D, Clifford DB, Collier AC, Gelman BB, Marra CM, McArthur JC, McCutchan JA, Morgello S, Sacktor N, Simpson DM, Franklin DR, Heaton RK, Grant I, Letendre SL
Year: 2017
Publication: The Journal of Infectious Diseases
Volume: 215 Issue: 1 Pages: 105-113
Abstract:BACKGROUND:  Neurocognitive disorders remain common among HIV+ adults, perhaps due to persistent HIV-1 RNA in cerebrospinal fluid (CSF) during antiretroviral therapy (ART). METHODS:  Using a single copy assay, we measured HIV-1 RNA in CSF and plasma from 220 HIV+ adults who were taking suppressive ART. Fifty-five participants were tested twice. RESULTS:  HIV-1 RNA was detected in 42.3% of CSF and 65.2% of plasma samples. Correlates of higher CSF HIV-1 RNA included higher nadir and current CD4+ counts, plasma HIV-1 RNA≥1 c/mL, and lower CPE values (Model p<0.001). Worse neurocognitive (NC) performance was associated with the HIV-1 RNA discordance, lower overall CSF HIV-1 RNA, and longer ART duration among others (Model p<0.001). In the longitudinal subgroup, CSF HIV-1 RNA persisted in most (69%) participants over 7 months. CONCLUSIONS:  Low-level HIV-1 RNA in CSF is common during suppressive ART and is associated with low-level HIV-1 RNA in blood, better immune status, and lower ART drug distribution into CSF. The association between HIV-1 RNA discordance and HAND may reflect compartmentalization. The relationship between HAND, lower HIV-1 RNA in CSF, and lower CD4+ counts may reflect disturbances in the immune response to HIV-1 in the CNS.

return to publications listing