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Asymptomatic Cerebrospinal Fluid HIV-1 Viral Blips and Viral Escape During Antiretroviral Therapy: A Longitudinal Study.

Journal article
Authors Arvid Edén
Staffan Nilsson
Lars Hagberg
Dietmar Fuchs
Henrik Zetterberg
Bo Svennerholm
Magnus Gisslén
Published in The Journal of infectious diseases
Volume 214
Issue 12
Pages 1822-1825
ISSN 1537-6613
Publication year 2016
Published at Department of Mathematical Sciences, Applied Mathematics and Statistics
Institute of Biomedicine, Department of Infectious Medicine
Pages 1822-1825
Language en
Subject categories Neurochemistry, Infectious Medicine


We examined longitudinal cerebrospinal fluid (CSF) samples (median, 5 samples/patients; interquartile range [IQR], 3-8 samples/patient) in 75 neurologically asymptomatic human immunodeficiency virus (HIV)-infected patients receiving antiretroviral therapy. Twenty-seven patients (36%) had ≥1 CSF HIV RNA load of >20 copies/mL (23% had ≥1 load of >50 copies/mL), with a median HIV RNA load of 50 copies/mL (IQR, 32-77 copies/mL). In plasma, 42 subjects (52%) and 22 subjects (29%) had an HIV RNA load of >20 and >50 copies/mL, respectively. Two subjects had an increasing virus load in consecutive CSF samples, representing possible CSF escape. Of 418 samples, 9% had a CSF HIV RNA load of >20 copies/mL (5% had a load of >50 copies/mL) and 19% had a plasma HIV RNA load of >20 copies/mL (8% had a load of >50 copies/mL). A CSF-associated virus load of >20 copies/mL was associated with higher CSF level of neopterin. In conclusion, CSF escape was rare, and increased CSF HIV RNA loads usually represented CSF virus load blips.

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