Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load

Michael J. Peluso, Francesca Ferretti, Julia Peterson, Evelyn Lee, Dietmar Fuchs, Antonio Boschini, Magnus Gisslén, Nancy Angoff, Richard W. Price, Paola Cinque, Serena Spudich

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To characterize HIV-infected patients with neurosymptomatic cerebrospinal fluid (CSF) 'escape', defined as detectable CSF HIV RNA in the setting of treatment-suppressed plasma levels or CSF RNA more than 1-log higher than plasma RNA. DESIGN: Retrospective case series. SETTING: Four urban medical centers in the United States and Europe. PARTICIPANTS: Virologically controlled HIV-infected patients on antiretroviral therapy (ART) with progressive neurologic abnormalities who were determined to have CSF 'escape'. INTERVENTION: Optimization of ART based upon drug susceptibility and presumed central nervous system exposure. MAIN OUTCOME MEASURES: Levels of CSF HIV RNA and inflammatory markers, clinical signs and symptoms, and MRI findings. RESULTS: Ten patients presented with new neurologic abnormalities, which included sensory, motor, and cognitive manifestations. Median CSF HIV RNA was 3900copies/ml (range 134-9056), whereas median plasma HIV RNA was 62copies/ml (range

Original languageEnglish
Pages (from-to)1765-1774
Number of pages10
JournalAIDS (London, England)
Volume26
Issue number14
DOIs
Publication statusPublished - Sep 10 2012

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Keywords

  • antiretroviral therapy
  • central nervous system
  • cerebrospinal fluid
  • HIV
  • HIV drug resistance
  • HIV pathogenesis
  • neurologic manifestations

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Peluso, M. J., Ferretti, F., Peterson, J., Lee, E., Fuchs, D., Boschini, A., Gisslén, M., Angoff, N., Price, R. W., Cinque, P., & Spudich, S. (2012). Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. AIDS (London, England), 26(14), 1765-1774. https://doi.org/10.1097/QAD.0b013e328355e6b2