Cerebrospinal fluid in HIV-1 systemic viral controllers: Absence of HIV-1 RNA and intrathecal inflammation

John C. Probasco, Steven G. Deeks, Evelyn Lee, Rebecca Hoh, Peter W. Hunt, Teri Liegler, Richard W. Price, Serena S. Spudich

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: A subset of HIV-infected patients, termed 'elite' viral controllers, maintain undetectable plasma HIV RNA levels in the absence of therapy. In this group, host-mediated viral control may be accompanied by chronic systemic inflammation. It is unknown whether either infection or chronic inflammation is present within the central nervous system of these individuals. METHODS: Cross-sectional analysis compared cerebrospinal fluid (CSF) HIV RNA and biomarkers of intrathecal inflammation in eight controllers (plasma HIV RNA levels <50 copies/ml) with 26 HIV-uninfected individuals, 25 untreated individuals HIV-infected, viremic individuals, and 23 HIV-infected individuals with treatment-mediated viral suppression (plasma HIV RNA levels <50 copies/ml). RESULTS: All controllers had CSF HIV RNA levels below 2.5 copies/ml. CSF white blood cell (WBC) counts and CSF: plasma albumin ratios in the controllers were similar to those in both HIV-uninfected individuals and antiretroviral therapy-suppressed HIV-infected individuals. CSF neopterin, MCP-1, and IP-10 concentrations were also not different in the controllers from either HIV-uninfected or treated HIV-infected individuals. CONCLUSION: The character of CSF HIV infection and degree of immunoactivation in controllers is comparable to that of HIV-uninfected and antiretroviral therapy-suppressed HIV-infected individuals, but distinct from that of untreated, viremic HIV-infected individuals.

Original languageEnglish (US)
Pages (from-to)1001-1005
Number of pages5
JournalAIDS
Volume24
Issue number7
DOIs
StatePublished - Apr 2010

Keywords

  • Central nervous system
  • Cerebrospinal fluid
  • HIV RNA
  • HIV controllers
  • Intrathecal inflammation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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