Prevalence of detectable HIV-DNA and HIV-RNA in cerebrospinal fluid of youth with perinatal HIV and impaired cognition on antiretroviral therapy.
AIDS
; 38(10): 1494-1504, 2024 Aug 01.
Article
in En
| MEDLINE
| ID: mdl-38814693
ABSTRACT
OBJECTIVE:
Central nervous system (CNS) HIV infection can impact cognition and may be an obstacle to cure in adolescents and young adults with perinatal HIV (AYAPHIV). IMPAACT2015 enrolled AYAPHIV on suppressive antiretroviral therapy (ART) with cognitive impairment to detect and quantify HIV in blood and cerebrospinal fluid (CSF).DESIGN:
IMPAACT2015 was a U.S.-based multi-site, exploratory, observational study.METHODS:
Cognitive impairment was defined as NIH Toolbox Fluid Cognition Composite score (FCCS) more than 1 standard deviation below age-adjusted normative group mean. Cell-free HIV-RNA and cell-associated HIV pol/gag -DNA and 10 biomarkers of inflammation/neuronal injury were measured in paired CSF and blood. ART exposure concentrations were quantified in hair.RESULTS:
Among 24 participants, 20 had successful CSF collection and 18 also met viral suppression criteria. Nine of 18 (50%) were female sex-at-birth, and 14 of 18 (78%) were black. Median (range) age was 20âyears (13-27), time on ART was 18.3âyears (8.0-25.5), and FCCS was 68 (53-80). HIV-DNA was detected in PBMCs from all participants. In CSF, two of 18 (11%, 95% CI 1.4-34.7%) participants had detectable cell-free HIV-RNA, while HIV gag or pol -DNA was detectable in 13 of 18 (72%, 95% confidence interval 47-90). Detectable HIV-DNA in CSF was associated with male sex-at-birth ( P â=â0.051), lower CD4 + cell count at enrollment ( P â=â0.016), and higher PBMC HIV pol -DNA copies ( P â=â0.058). Hair antiretroviral concentrations and biomarkers were not associated with CSF HIV-DNA detection.CONCLUSION:
We found that a high proportion of AYAPHIV with neurocognitive impairment had CSF cells harboring HIV-DNA during long-term virologic suppression. This evidence of persistent HIV-DNA in CSF suggests that the CNS should be considered in treatment and cure studies.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
DNA, Viral
/
RNA, Viral
/
HIV Infections
/
Anti-Retroviral Agents
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
AIDS
/
AIDS (Lond.)
/
AIDS (London, England)
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: