Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection

Abdulle, Sahra,1970-,Göteborgs universitet, Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar (författare)

OBJECTIVE: To study the effect of antiretroviral combination treatment on intrathecal immunoactivation in HIV-1 infection. METHOD: Lumbar punctures were performed at baseline, and after 4 months, 1 and 2 years on 30 neurologically asymptomatic, treatment-naive HIV-1-infected patients started on antiretroviral treatment with three or more drugs. Levels of neopterin, beta2-microglobulin and HIV-1 RNA were measured in cerebrospinal fluid (CSF) and blood. RESULTS: All patients continued the study until the 4-month follow-up, although seven discontinued before the 1-year control, and an additional five discontinued before the control after 2 years. Neopterin, beta2-microglobulin and HIV-1 RNA decreased significantly both in CSF and blood, but although 100% of the patients decreased their CSF concentrations of beta2-microglobulin and HIV-1 RNA to normal levels, only 55% had normal CSF neopterin concentrations after 2 years treatment. CONCLUSIONS: In addition to CSF viral load, antiretroviral combination therapy substantially decreases the intrathecal immunoactivation as reflected by CSF neopterin and beta2-microglobulin in neuroasymptomatic HIV-1-infected patients. However, almost half of the patients still have slightly increased CSF neopterin concentrations after 2 years of effective treatment, which might reflect an ongoing low-grade viral replication in brain tissue.

MEDICIN OCH HÄLSOVETENSKAP Medicinska grundvetenskaper Mikrobiologi inom det medicinska området hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Microbiology in the medical area hsv//eng
Mikrobiologi, immunologi, infektionssjukdomar
Microbiology, immunology, infectious diseases
Adult
Anti-HIV Agents/*therapeutic use
Drug Combinations
Female
HIV Infections/blood/cerebrospinal fluid/*drug therapy
Humans
Male
Middle Aged
Neopterin/blood/cerebrospinal fluid
RNA
Viral/blood/cerebrospinal fluid
Viral Load
beta 2-Microglobulin/blood/cerebrospinal fluid

Hagberg, Lars,1951-,Göteborgs universitet, Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar(SwePub:scigloo)80332 (författare)
Svennerholm, Bo,1949-,Göteborgs universitet, Institutionen för laboratoriemedicin, Avdelningen för klinisk virologi(SwePub:scigloo)61926 (författare)
Fuchs, Dietmar(SwePub:scigloo)77414 (författare)
Gisslén, Magnus,1962-,Göteborgs universitet, Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar(SwePub:scigloo)61923 (författare)
Göteborgs universitet.Sahlgrenska akademin.Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar.(SwePub:scigloo)1094
University of Gothenburg.Sahlgrenska Academy.Institute of Internal Medicine, Dept of Infectious Diseases.(SwePub:scigloo)1094
Göteborgs universitet.Sahlgrenska akademin.Institutionen för laboratoriemedicin, Avdelningen för klinisk virologi.(SwePub:scigloo)1106
University of Gothenburg.Sahlgrenska Academy.Institute of Laboratory Medicine, Dept of Clinical Virology.(SwePub:scigloo)1106

Av författaren/redakt...: Abdulle, Sahra, ...; Hagberg, Lars, 1 ...; Svennerholm, Bo, ...; Fuchs, Dietmar; Gisslén, Magnus, ...

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