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Peripheral and cerebrospinal fluid immune activation and inflammation in chronically HIV-infected patients before and after virally suppressive combination antiretroviral therapy (cART).
- Source :
-
Journal of neurovirology [J Neurovirol] 2018 Dec; Vol. 24 (6), pp. 679-694. Date of Electronic Publication: 2018 Jul 09. - Publication Year :
- 2018
-
Abstract
- Cerebrospinal fluid (CSF)/plasma HIV-RNA ratio has been associated with residual neurocognitive impairment on cART, leading us to hypothesize a specific peripheral and/or CSF immune feature in patients with high CSF/plasma ratio (≥ 1). In patients with diverse pre-cART CSF/plasma ratio (61/70 with CSF/plasma ratio < 1, L-CSF, 9/70 with CSF/plasma ratio ≥ 1, H-CSF), we investigated the effects of 12 months of effective cART on peripheral and CSF inflammatory markers, on T cell activation/maturation and HIV/CMV-specific intracellular cytokine pattern. We also studied the possible clinical association between peripheral/CSF pro-inflammatory milieu and neurocognitive screening tests (MMSE, FAB, IHDS). Prior to cART, the two groups were comparable for peripheral and CSF inflammation, T cell activation/proliferation and maturation, and HIV/CMV-specific response. Upon cART initiation, both H-CSF and L-CSF featured a significant reduction in plasma TNF-α and circulating CD8 activation, with a redistribution of memory/naïve T cell subsets in L-CSF alone. In the CSF compartment, cART seemed able to reduce pro-inflammatory cytokine/chemokine levels in both H-CSF and L-CSF patients. Interestingly, despite a reduction in the pro-inflammatory milieu, no changes were shown in neurocognitive screening tests in both patients' groups. We hereby show that 12-month cART is able to reduce intratechal and peripheral pro-inflammatory burden; a longer cART exposure and a more comprehensive neuropsychological evaluation might be necessary to gain a broader insight into the possible effects on neurocognitive performance.
- Subjects :
- AIDS Dementia Complex cerebrospinal fluid
AIDS Dementia Complex drug therapy
Adult
Female
Humans
Male
Middle Aged
RNA, Viral blood
RNA, Viral cerebrospinal fluid
AIDS Dementia Complex immunology
Anti-HIV Agents therapeutic use
HIV Infections cerebrospinal fluid
HIV Infections drug therapy
HIV Infections immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1538-2443
- Volume :
- 24
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of neurovirology
- Publication Type :
- Academic Journal
- Accession number :
- 29987585
- Full Text :
- https://doi.org/10.1007/s13365-018-0661-1