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Anti-Human Immunodeficiency Virus Antibodies in the Cerebrospinal Fluid: Evidence of Early Treatment Impact on Central Nervous System Reservoir?

Artikel i vetenskaplig tidskrift
Författare P. D. Burbelo
R. W. Price
Lars Hagberg
H. Hatano
S. Spudich
S. G. Deeks
Magnus Gisslén
Publicerad i Journal of Infectious Diseases
Volym 217
Nummer/häfte 7
Sidor 1024-1032
ISSN 0022-1899
Publiceringsår 2018
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 1024-1032
Språk en
Ämnesord anti-retroviral therapy, antibodies, central nervous system, cerebrospinal fluid, early infection, HIV-1, persistence, serology
Ämneskategorier Infektionsmedicin

Sammanfattning

Background Despite effective antiretroviral therapy (ART), human immunodeficiency virus (HIV) likely persists in the central nervous system (CNS) in treated individuals. We examined anti-HIV antibodies in cerebrospinal fluid (CSF) and blood as markers of persistence. Methods Human immunodeficiency virus antibodies were measured in paired CSF and serum before and after long-term treatment of chronic (n = 10) and early infection (n = 12), along with untreated early infection (n = 10). Results Treatment of chronic infection resulted in small reductions of anti-HIV antibodies in CSF and serum despite >10 years of suppressive ART. In untreated early infection, anti-HIV antibodies emerged in blood by day 30, whereas CSF antibodies reached similar levels 2 weeks later. Compared with long-term treatment of chronic infection, early ART initiation reduced CSF antibodies by 43-fold (P >.0001) and blood antibodies by 7-fold (P =.0003). Two individuals receiving pre-exposure prophylaxis and then ART early after infection failed to develop antibodies in CSF or blood, whereas CSF antibodies were markedly reduced in the Berlin patient. Conclusions To the extent that differential CSF and blood antibodies indicate HIV persistence, these data suggest a relative delay in establishment of the CNS compared with the systemic HIV reservoir that provides an opportunity for early treatment to have a greater impact on the magnitude of long-term CNS infection.

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Denna text är utskriven från följande webbsida:
http://www.gu.se/forskning/publikation/?publicationId=266190
Utskriftsdatum: 2020-02-26