Cerebrospinal fluid compartmentalization of HIV-1 and correlation with plasma viral load and blood–brain barrier damage

• Published in: Infection 2019-06, Vol.47 (3), p.441-446
• Main Authors: Bavaro, Davide Fiore, Calamo, A., Lepore, L., Fabrizio, C., Saracino, A., Angarano, G., Monno, L.
• Format: Article
• Language: English
• Subjects: Abnormalities; Acquired immune deficiency syndrome; AIDS; Antiretroviral drugs; Antiretroviral therapy; Blood; Blood-brain barrier; Brain damage; Brain injury; Cerebrospinal fluid; Damage assessment; Data processing; Discordance; Divergence; Family Medicine; Gene sequencing; General Practice; HIV; Human immunodeficiency virus; Infectious Diseases; Internal Medicine; Medicine; Medicine & Public Health; Mutation; Neurophysiology; Original Paper; Patients; Plasma; Ribonucleic acid; RNA; Tropism
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-019-01268-8

Purpose We aimed to evaluate HIV-1 compartmentalization between the cerebrospinal fluid (CSF) and plasma and investigate as to which extent HIV-1 strains in CSF differ from those in blood and whether a correlation with either plasma viral load (pVL) or an altered blood–brain barrier (BBB) does exist. Study design We retrospectively evaluated paired CSF/blood samples collected from 86 HIV+ patients. HIV-RNA quantification, pol (PR/RT), and V3 sequencing were performed. HIV coreceptor tropism (CRT) was inferred (g2p, false-positive rate 10%, FPR). Data of standard CSF analysis were also reviewed; an altered CSF/plasma albumin ratio signified BBB damage. Neurological abnormalities (NA) were recorded. Results Overall, 32% of patients had a CSF/plasma HIV-RNA ratio > 1 ( discordance ); 3% of patients had detectable CSF HIV-RNA despite suppressed pVL ( escape ). Discordance was more frequent in ART-treated patients ( p