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Titolo:
Time course of cerebrospinal fluid responses to antiretroviral therapy: evidence for variable compartmentalization of infection
Autore:
Staprans, S; Marlowe, N; Glidden, D; Novakovic-Agopian, T; Grant, RM; Heyes, M; Aweeka, F; Deeks, S; Price, RW;
Indirizzi:
Univ Calif San Francisco, Dept Med, San Francisco, CA USA Univ Calif San Francisco San Francisco CA USA Med, San Francisco, CA USA Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 Univ Calif San Francisco San Francisco CA USA 94143 n Francisco, CA 94143 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Dept Clin Pharmacol, San Francisco, CA 94143 USAUniv Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA NIMH, Gladstone Inst Virol & Immunol, Bethesda, MD 20892 USA NIMH Bethesda MD USA 20892 e Inst Virol & Immunol, Bethesda, MD 20892 USA NIMH, Lab Neurotoxicol, Bethesda, MD 20892 USA NIMH Bethesda MD USA 20892NIMH, Lab Neurotoxicol, Bethesda, MD 20892 USA
Titolo Testata:
AIDS
fascicolo: 9, volume: 13, anno: 1999,
pagine: 1051 - 1061
SICI:
0269-9370(19990618)13:9<1051:TCOCFR>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
VIRUS TYPE-1 RNA; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; HIV-1 RNA; VIRAL LOAD; HIV-1-INFECTED PATIENTS; QUINOLINIC ACID; NEUROLOGICAL DISORDERS; COMBINATION THERAPY; ZIDOVUDINE; DEMENTIA;
Keywords:
AIDS; AIDS dementia complex; antiviral; cerebrospinal fluid; HIV; meningitis; quinolinic acid; RNA; treatment; viral load;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Price, RW San Francisco Gen Hosp, Room 4M62,1001 Potrero Ave, San Francisco, CA 94110 San Francisco Gen Hosp Room 4M62,1001 Potrero Ave San FranciscoCA USA 94110
Citazione:
S. Staprans et al., "Time course of cerebrospinal fluid responses to antiretroviral therapy: evidence for variable compartmentalization of infection", AIDS, 13(9), 1999, pp. 1051-1061

Abstract

Objectives: To compare the kinetics and magnitude of HIV-1 RNA responses to antiretroviral therapy (ART) in the cerebrospinal fluid (CSF) and plasma. Design: Repeated lumbar punctures (LPs) were performed after the initiation or change in ART in 15 HIV-1-infected subjects, with the focus on two phases of response: an acute phase within the first 11 days, for which crude estimates of viral RNA half-lives and decay rates were derived and CSF : plasma relative decay ratios quantitatively analysed; and a longer-term phase beyond 4 weeks that was descriptively assessed. Results: In 13 subjects studied during the acute phase, the crude HIV-1 RNA half-life was longer (median 2.0 compared with 1.9 days), the decay rate slower (median 0.13 compared with 0.16 log(10) copies/day) and, most notably, the variability greater (intraquartile range of half-life 1.8-4.3 compared with 1.7-2.1 days) in the CSF than in the plasma. A slower decay in the CSF correlated with lower initial blood CD4 T lymphocyte counts (P = 0.001). Seven of 11 subjects studied at 4 weeks or later, including some with slower acute-phase CSF responses, showed greater or more durable viral suppression in the CSF. Conclusion: Divergent acute-phase viral kinetics in the CSF and plasma, and proportionally greater long-term decrements in CSF HIV-1 RNA in slow early-responders or poor overall plasma responders indicate variable compartmentalization of CSF infection, consistent with a model of two prototypes of CSF infection: short-lived, transitory infection that predominates in early HIV-1 infection and longer-lived, more autonomous CSF infection predominating in late HIV-1 infection. Additional studies will be needed to define more precisely the acute and longer-term CSF kinetics in different clinical settings and to assess this model. (C) 1999 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 01:32:25