Minimal detection of cerebrospinal fluid escape after initiation of antiretroviral therapy in acute HIV-1 infection
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: Despite suppression of HIV-1 replication in the periphery by antiretroviral therapy (ART), up to 10% of treated individuals have quantifiable HIV-1 in the CSF, termed CSF escape. CSF escape may be asymptomatic but has also been linked to progressive neurological disease, and may indicate persistence of HIV in the central nervous system (CNS). CSF escape has not yet been assessed after initiation of ART during acute HIV-1 infection (AHI).
DESIGN: Prospective cohort study.
SETTING: Major voluntary counseling and testing site in Bangkok, Thailand.
PARTICIPANTS: Participants identified and initiated on ART during AHI who received an optional study lumbar puncture at pre-ART baseline or after 24 or 96 weeks of ART.
MAIN OUTCOME MEASURES: Paired levels of CSF and plasma HIV-1 RNA, with CSF greater than plasma HIV-1 RNA defined as CSF escape.
RESULTS: Two hundred and four participants had paired blood and CSF sampling in at least one visit at baseline, week 24, or week 96. Twenty-nine participants had CSF sampling at all three visits. CSF escape was detected in 1/90 at week 24 (CSF HIV-1 RNA 2.50 log10 copies/ml, plasma HIV-1 RNA <50 copies/ml), and 0/55 at week 96.
CONCLUSION: Although levels of CSF HIV-1 RNA in untreated AHI are high, initiating treatment during AHI results in a very low rate of CSF escape in the first 2 years of treatment. Early treatment may improve control of HIV-1 within the CNS compared with treatment during chronic infection, which may have implications for long-term neurological outcomes and CNS HIV-1 persistence.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
AIDS (London, England) - 35(2021), 5 vom: 01. Apr., Seite 777-782 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Handoko, Ryan [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Retroviral Agents |
|---|
| Anmerkungen: |
Date Completed 27.04.2021 Date Revised 21.09.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/QAD.0000000000002786 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM318718774 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM318718774 | ||
| 003 | DE-627 | ||
| 005 | 20231225165933.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/QAD.0000000000002786 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1062.xml |
| 035 | |a (DE-627)NLM318718774 | ||
| 035 | |a (NLM)33306551 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Handoko, Ryan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Minimal detection of cerebrospinal fluid escape after initiation of antiretroviral therapy in acute HIV-1 infection |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.04.2021 | ||
| 500 | |a Date Revised 21.09.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Despite suppression of HIV-1 replication in the periphery by antiretroviral therapy (ART), up to 10% of treated individuals have quantifiable HIV-1 in the CSF, termed CSF escape. CSF escape may be asymptomatic but has also been linked to progressive neurological disease, and may indicate persistence of HIV in the central nervous system (CNS). CSF escape has not yet been assessed after initiation of ART during acute HIV-1 infection (AHI) | ||
| 520 | |a DESIGN: Prospective cohort study | ||
| 520 | |a SETTING: Major voluntary counseling and testing site in Bangkok, Thailand | ||
| 520 | |a PARTICIPANTS: Participants identified and initiated on ART during AHI who received an optional study lumbar puncture at pre-ART baseline or after 24 or 96 weeks of ART | ||
| 520 | |a MAIN OUTCOME MEASURES: Paired levels of CSF and plasma HIV-1 RNA, with CSF greater than plasma HIV-1 RNA defined as CSF escape | ||
| 520 | |a RESULTS: Two hundred and four participants had paired blood and CSF sampling in at least one visit at baseline, week 24, or week 96. Twenty-nine participants had CSF sampling at all three visits. CSF escape was detected in 1/90 at week 24 (CSF HIV-1 RNA 2.50 log10 copies/ml, plasma HIV-1 RNA <50 copies/ml), and 0/55 at week 96 | ||
| 520 | |a CONCLUSION: Although levels of CSF HIV-1 RNA in untreated AHI are high, initiating treatment during AHI results in a very low rate of CSF escape in the first 2 years of treatment. Early treatment may improve control of HIV-1 within the CNS compared with treatment during chronic infection, which may have implications for long-term neurological outcomes and CNS HIV-1 persistence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 7 | |a Anti-Retroviral Agents |2 NLM | |
| 650 | 7 | |a RNA, Viral |2 NLM | |
| 700 | 1 | |a Chan, Phillip |e verfasserin |4 aut | |
| 700 | 1 | |a Jagodzinski, Linda |e verfasserin |4 aut | |
| 700 | 1 | |a Pinyakorn, Suteeraporn |e verfasserin |4 aut | |
| 700 | 1 | |a Ubolyam, Sasiwimol |e verfasserin |4 aut | |
| 700 | 1 | |a Phanuphak, Nittaya |e verfasserin |4 aut | |
| 700 | 1 | |a Sacdalan, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Kroon, Eugene |e verfasserin |4 aut | |
| 700 | 1 | |a Dumrongpisutikul, Netsiri |e verfasserin |4 aut | |
| 700 | 1 | |a Paul, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Valcour, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Ananworanich, Jintanat |e verfasserin |4 aut | |
| 700 | 1 | |a Vasan, Sandhya |e verfasserin |4 aut | |
| 700 | 1 | |a Spudich, Serena |e verfasserin |4 aut | |
| 700 | 0 | |a SEARCH010/RV254 Study Team |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t AIDS (London, England) |d 1988 |g 35(2021), 5 vom: 01. Apr., Seite 777-782 |w (DE-627)NLM012619280 |x 1473-5571 |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2021 |g number:5 |g day:01 |g month:04 |g pages:777-782 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/QAD.0000000000002786 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2021 |e 5 |b 01 |c 04 |h 777-782 | ||