Cerebrospinal fluid pleocytosis as a predictive factor for CSF and plasma HIV RNA discordance and escape
| Autor: | de Almeida, Sérgio Monteiro, Rotta, Indianara, de Pereira, Ana Paula, Tang, Bin, Umlauf, Anya, Ribeiro, Cléa Elisa Lopes, Letendre, Scott, Ellis, Ronald J, HIV Neurobehavioral Research Center (HNRC) Group |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Discordance Leukocytosis Anti-HIV Agents Clinical Sciences Neurosciences HIV Infections Middle Aged Brain Disorders Cerebrospinal fluid Scape Central nervous system Clinical Research Medical Microbiology Virology HIV-1 Humans RNA HIV/AIDS Female Viral Infection HIV Neurobehavioral Research Center (HNRC) Group White blood cell |
| Zdroj: | Journal of neurovirology, vol 26, iss 2 |
| Popis: | The aims of this study were to investigate the frequency of HIV-1 RNA level discordance between the cerebrospinal fluid (CSF) and plasma and of CSF viral escape (CVE) in patients with HIV-1 subtype C on antiretroviral therapy, and evaluate the CSF white blood cell (WBC) performance characteristics in predicting CSF discordance in HIV+ group and the frequency of cognitive impairment in individuals with CSF HIV discordance or escape. HIV-1 RNA levels were assessed in plasma and CSF samples from 68 HIV+ participants without opportunistic infection. CSF discordance was found in 7.4% and CVE in 10%, with comparable frequencies between HIV-1B and C. Twenty samples (29%) showed increased CSF WBC counts. This group had higher CSF and plasma HIV-1 RNA levels than the group with normal WBC counts (p 5cells/mm3 than the group with normal CSF WBC count. CSF WBC counts (cut-off of 15cells/mm3) showed high-performance characteristics as a predictive biomarker of CSF discordance (AUC the ROC curve 0.98). The frequency of cognitive impairment for CSF escape or discordance was 83% and 80%. The odds of cognitive impairment in these groups were 19 and 15 times higher than those for an HIV(-) person. Viral discordance or escape in the CNS occurs at a comparable frequency for HIV-1C and HIV-1B. The CSF WBC count was effective as a predictive biomarker of CSF and plasma discordance. |
| Databáze: | OpenAIRE |
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