PMID- 36895097
OWN - NLM
STAT- MEDLINE
DCOM- 20230710
LR  - 20231116
IS  - 1468-1293 (Electronic)
IS  - 1464-2662 (Linking)
VI  - 24
IP  - 7
DP  - 2023 Jul
TI  - Cerebrospinal fluid virology in people with HIV.
PG  - 838-844
LID - 10.1111/hiv.13471 [doi]
AB  - OBJECTIVE: Our objectives were to investigate the recent frequency of 
      cerebrospinal fluid (CSF) HIV RNA escape and other CSF viral nucleic acid 
      detection in people with HIV with neurological symptoms and to assess associated 
      clinical factors. METHOD: This was a retrospective cohort analysis of people with 
      HIV who underwent CSF examination for clinical indications between 2017 and 2022. 
      Individuals were identified from pathology records, and clinical data were 
      recorded. CSF HIV RNA escape was defined as CSF HIV RNA concentrations greater 
      than in plasma. CSF viral screen included herpes simplex virus types 1 (HSV-1) 
      and 2 (HSV-2), varicella zoster virus (VZV), Epstein Barr virus (EBV), 
      cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and JC virus. When cases were 
      detected in five or more people with HIV, associated clinical factors were 
      assessed using linear regression modelling. RESULTS: CSF HIV RNA escape was 
      observed in 19 of 114 individuals (17%) and was associated with the presence of 
      HIV drug resistance mutations and non-integrase strand transfer inhibitor-based 
      antiretroviral therapy (p < 0.05 for all) when compared to people with HIV 
      without escape. Positive viral nucleic acid testing included EBV (n = 10), VZV 
      (3), CMV (2), HHV-6 (2) and JC virus (4). Detectable CSF EBV was not considered 
      related to neurological symptoms and was associated with concomitant CSF 
      infections in eight of ten individuals and with CSF pleocytosis, previous AIDS, 
      lower nadir and current CD4 T-cell count (p < 0.05 for all). CONCLUSION: In 
      people with HIV with neurological symptoms, the frequency of CSF HIV RNA escape 
      remains similar to that in historical reports. Detectable EBV viral nucleic acid 
      in the CSF was observed frequently and, in the absence of clinical 
      manifestations, may be a consequence of CSF pleocytosis.
CI  - (c) 2023 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of 
      British HIV Association.
FAU - Henderson, Merle
AU  - Henderson M
AUID- ORCID: 0000-0003-3326-9674
AD  - Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial 
      College London, London, UK.
AD  - Department of HIV and GU Medicine, St Mary's Hospital, Imperial College 
      Healthcare NHS Trust, London, UK.
FAU - Pepper, Nuala
AU  - Pepper N
AD  - Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial 
      College London, London, UK.
FAU - Bawa, Manraj
AU  - Bawa M
AD  - Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial 
      College London, London, UK.
FAU - Muir, David
AU  - Muir D
AD  - North West London Pathology, Charing Cross Hospital, Imperial College Healthcare 
      NHS Trust, London, UK.
FAU - Everitt, Alex
AU  - Everitt A
AD  - Department of Neurology, St. Mary's Hospital, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Mackie, Nicola E
AU  - Mackie NE
AD  - Department of HIV and GU Medicine, St Mary's Hospital, Imperial College 
      Healthcare NHS Trust, London, UK.
FAU - Winston, Alan
AU  - Winston A
AUID- ORCID: 0000-0002-5847-8416
AD  - Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial 
      College London, London, UK.
AD  - Department of HIV and GU Medicine, St Mary's Hospital, Imperial College 
      Healthcare NHS Trust, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20230309
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
RN  - 63231-63-0 (RNA)
RN  - 0 (DNA, Viral)
SB  - IM
MH  - Humans
MH  - *Herpesviridae Infections/cerebrospinal fluid/diagnosis
MH  - Herpesvirus 4, Human/genetics
MH  - *Epstein-Barr Virus Infections/complications
MH  - Retrospective Studies
MH  - Leukocytosis/complications
MH  - *HIV Infections/complications/drug therapy
MH  - Herpesvirus 3, Human/genetics
MH  - Cytomegalovirus
MH  - RNA
MH  - *Cytomegalovirus Infections
MH  - Cerebrospinal Fluid
MH  - DNA, Viral
OTO - NOTNLM
OT  - CSF
OT  - HIV infection
OT  - neurological
OT  - viral escape
OT  - viral infection
EDAT- 2023/03/11 06:00
MHDA- 2023/07/10 06:42
CRDT- 2023/03/10 00:12
PHST- 2022/10/10 00:00 [received]
PHST- 2023/02/08 00:00 [accepted]
PHST- 2023/07/10 06:42 [medline]
PHST- 2023/03/11 06:00 [pubmed]
PHST- 2023/03/10 00:12 [entrez]
AID - 10.1111/hiv.13471 [doi]
PST - ppublish
SO  - HIV Med. 2023 Jul;24(7):838-844. doi: 10.1111/hiv.13471. Epub 2023 Mar 9.