Low-level HIV-1 RNA in cerebrospinal fluid (CSF) is common during suppressive antiretroviral therapy (ART) and is associated with low-level HIV-1 RNA in blood, better immune status, and lower ART drug distribution into CSF, a recent study found. Using a single copy assay, the study measured HIV-RNA in CSF and plasma from 220 HIV-positive adults who were taking suppressive ART. 55 participants were tested twice. Researchers found:
- HIV-1 RNA was detected in 42.3% of CSF and in 65.2% of plasma samples.
- Correlates of higher CSF HIV-1 RNA included higher nadir and current CD4+ counts, plasma HIV-1 RNA≥1 c/mL, and lower CPE values.
- Worse neurocognitive performance was associated with the HIV-1 RNA discordance, lower overall CSF HIV-1 RNA, and longer ART duration among others.
- CSF HIV-1 RNA persisted in most (69%) participants over 7 months.
Anderson AM, Muñoz-Moreno JA, McClernon D, et al. Prevalence and correlates of persistent HIV-1 RNA in cerebrospinal fluid during antiretroviral therapy. [Published online ahead of print October 26, 2016]. J Infect Dis. doi:10.1093/infdis/jiw505.