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Cerebrospinal fluid viral load in HIV-1-infected patients without antiretroviral treatment: a longitudinal study

Journal article
Authors Magnus Gisslén
Lars Hagberg
Dietmar Fuchs
Gunnar Norkrans
Bo Svennerholm
Published in J Acquir Immune Defic Syndr Hum Retrovirol
Volume 17
Issue 4
Pages 291-5
Publication year 1998
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Laboratory Medicine, Dept of Clinical Virology
Pages 291-5
Language en
Keywords Adult, CD4 Lymphocyte Count, Cerebrospinal Fluid/*virology, Cohort Studies, Female, Follow-Up Studies, HIV Infections/cerebrospinal fluid/immunology/*virology, HIV-1/genetics/immunology/*physiology, Humans, Longitudinal Studies, Male, Middle Aged, Neopterin/blood/cerebrospinal fluid, Polymerase Chain Reaction, RNA, Viral/blood/*cerebrospinal fluid, *Viral Load
Subject categories Microbiology in the medical area


HIV-1 RNA and neopterin levels were observed longitudinally for 20 to 68 months (mean, 37.5 months) in cerebrospinal fluid (CSF) and serum in 15 HIV-1-infected patients not receiving antiretroviral treatment. During the course of infection the HIV-1 RNA levels increased significantly in CSF, from a mean of 3.08 to 3.51 log10 copies RNA/ml (p < .01). A significant positive correlation was found between the CSF levels of HIV-I RNA and neopterin (rs = 0.54; p < .001), which increased from 13.6 to 19.6 nmol/L (p < .01). No significant changes in HIV-1 RNA or neopterin levels were found in serum. We suggest that the increase of CSF viral load with time in HIV-1 infection triggers an intrathecal immune activation reflected by increased CSF levels of neopterin. These results are in accordance with the theory that a chronic immune stimulation within the central nervous system (CNS) is involved in the pathogenesis of neurologic HIV-1 disease.

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