Safety of lumbar puncture procedure in an international research setting during acute HIV infection
| Autor: | Carlo Sacdalan, Donn J Colby, Joanna Hellmuth, Payal Patel, James L. K. Fletcher, Phillip Chan, Victor Valcour, Suteera Pinyakorn, Eugene Kroon, Jintanat Ananworanich, Serena Spudich |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Epidemiology Immunology Subgroup analysis Microbiology 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Virology Internal medicine medicine 030212 general & internal medicine Lumbar puncture headache acute HIV infection cerebrospinal fluid atraumatic spinal needle RV254 Original Research 2. Zero hunger medicine.diagnostic_test Lumbar puncture business.industry Public Health Environmental and Occupational Health Lumbar Puncture Headache QR1-502 3. Good health Acute Retroviral Syndrome Infectious Diseases Headaches medicine.symptom Public aspects of medicine RA1-1270 business Body mass index Viral load 030217 neurology & neurosurgery |
| Zdroj: | Journal of Virus Eradication Journal of Virus Eradication, Vol 4, Iss 1, Pp 16-20 (2018) |
| ISSN: | 2055-6659 2055-6640 |
| Popis: | Background: Cerebrospinal fluid (CSF) sampling at the time of acute HIV infection (AHI) is crucial in understanding NeuroAIDS pathogenesis. Here, we report on the safety of performing a lumbar puncture (LP) during untreated AHI and follow-up after initiation of combination antiretroviral therapy (cART). Methods: We reviewed clinical records of participants who took part in an AHI protocol in Bangkok, Thailand, including untreated AHI subjects (baseline), and longitudinal visits following immediate initiation of cART to assess rates and risk of post-lumbar puncture headaches (PLPH). A cerebrospinal fluid (CSF) volume of 10–20 mL was collected using standard cutting-edge or atraumatic needles. Results: From April 2009 to February 2016, 195 LPs were performed, of which 89 (46%) were at baseline. The LP procedures at baseline were not associated with an additional PLPH risk as compared to repeat LPs after cART initiation (26/89 [29%] vs 4/27 [15%], respectively; P=0.134). Higher body mass index (BMI) at baseline (P=0.070) and use of an atraumatic needle (P=0.058) had trend-level associations with reduced PLPH. A higher CSF volume collection (20 mL) was independently associated with a lower PLPH frequency (P=0.024). This association was similar in a subgroup analysis with the use of atraumatic needles. The CD4+ T lymphocyte count, blood and CSF HIV viral load, Fiebig staging, and the presence of an acute retroviral syndrome did not correlate with risk for PLPH (all P>0.05). Conclusion: The frequency of PLPH during AHI was similar to that seen in the setting of cART-treated HIV infection and not higher with a larger CSF volume collection. Our study adds to the existing evidence that atraumatic needles should be used to minimise the risk of PLPH. |
| Databáze: | OpenAIRE |
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