Temporal Patterns and Drug Resistance in CSF Viral Escape Among ART-Experienced HIV-1 Infected Adults
| Autor: | Jennifer L. Lyons, Nagagopal Venna, Susan Morgello, Igor J. Koralnik, Spyridon Chalkias, Vikas Misra, Alysse Wurcel, David R Lorenz, Deirdre Burke, Shibani S. Mukerji, Anna M. Cervantes-Arslanian, Dana Gabuzda |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male 030106 microbiology antiretroviral therapy Human immunodeficiency virus (HIV) Viremia HIV Infections Drug resistance CSF viral escape medicine.disease_cause cerebrospinal fluid 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Translational Research Drug Resistance Viral Medicine Humans Pharmacology (medical) 030212 general & internal medicine drug resistance mutations Immune Evasion Retrospective Studies business.industry RNA Retrospective cohort study Middle Aged Viral Load Resistance mutation medicine.disease United States 3. Good health CD4 Lymphocyte Count Infectious Diseases Immunology ComputingMethodologies_DOCUMENTANDTEXTPROCESSING HIV-1 RNA Viral Female business Viral load |
| Zdroj: | Journal of Acquired Immune Deficiency Syndromes (1999) |
| ISSN: | 1944-7884 1525-4135 |
| Popis: | Supplemental Digital Content is Available in the Text. Background: Cerebrospinal fluid (CSF) viral escape is an increasingly recognized clinical event among HIV-1-infected adults. We analyzed longitudinal data and drug-resistance mutations to characterize profiles of HIV-1-infected patients on antiretroviral therapy with discordant CSF and plasma HIV-1 RNA levels. Methods: Forty-one cases of CSF escape defined as detectable CSF HIV-1 RNA when plasma levels were undetectable, or HIV-1 RNA >0.5-log higher in CSF than plasma were identified from Boston Hospitals and National NeuroAIDS Tissue Consortium (NNTC) from 2005 to 2016. Results: Estimated prevalence of CSF escape in Boston and NNTC cohorts was 6.0% and 6.8%, respectively; median age was 50, duration of HIV-1 infection 17 years, CD4 count 329 cells/mm3 and CD4 nadir 21 cells/mm3. Neurological symptoms were present in 30 cases; 4 had repeat episodes of CSF escape. Cases were classified into subtypes based plasma HIV-1 RNA levels in the preceding 24 months: high-level viremia (1000 copies/mL), low-level viremia (LLV: 51–999 copies/mL), and plasma suppression with CSF blip or escape (CSF RNA 15 years, previous LLV, and M184V/I mutations in CSF. Classification based on preceding plasma HIV RNA levels provides a useful conceptual framework to identify causal factors and test therapeutics. |
| Databáze: | OpenAIRE |
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