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Absence of Cerebrospinal Fluid Signs of Neuronal Injury Before and After Immediate Antiretroviral Therapy in Acute HIV Infection
- Source :
- The Journal of infectious diseases, vol 212, iss 11
- Publication Year :
- 2015
- Publisher :
- eScholarship, University of California, 2015.
-
Abstract
- BackgroundIt is unknown whether neuronal injury begins during acute human immunodeficiency virus (HIV) infection, and whether immediate initiation of combination antiretroviral therapy (cART) prevents neuronal injury.MethodsCerebrospinal fluid (CSF) neurofilament light chain (NFL), a measure of axonal injury, was assessed before and after cART initiation in individuals starting treatment during acute or chronic HIV infection. Nonparametric statistics examined relationships between NFL and disease progression, neuroinflammation, and cognitive performance.ResultsBefore treatment, subjects with acute infection had lower CSF NFL levels, with elevations for their age in 1 of 32 subjects with acute infection (3.1%) and 10 of 32 with chronic infection (31%) (P = .006). This persisted after cART initiation, with 1 of 25 acute (4%) and 4 of 9 chronic subjects (44%) showing elevated NFL levels (P = .01). In acute infection, pre-cART NFL levels were inversely correlated with proton magnetic resonance spectroscopic findings of N-acetylaspartate/creatine in frontal gray matter (r = -0.40; P = .03), frontal white matter (r = -0.46; P = .01), and parietal gray matter (r = -0.47; P = .01); correlations persisted after treatment in the frontal white matter (r = -0.51; P = .02) and parietal gray matter (r = -0.46; P = .04).ConclusionsCSF NFL levels are not elevated in untreated acute HIV infection or after 6 months of immediately initiated cART but are abnormal in chronic HIV infection before and after treatment. In acute HIV infection, CSF NFL levels are inversely associated with neuroimaging markers of neuronal health.
- Subjects :
- Adult
Male
antiretroviral therapy
HIV Infections
Neuroimaging
Medical and Health Sciences
Microbiology
neuroinflammation
Cohort Studies
Young Adult
Neurofilament Proteins
Clinical Research
Humans
RV254/SEARCH 010 and SEARCH 011 Study Teams
Neurosciences
Biological Sciences
Magnetic Resonance Imaging
magnetic resonance spectroscopy
neurological injury
neurofilament light chain
Infectious Diseases
Good Health and Well Being
Anti-Retroviral Agents
HIV/AIDS
Female
Infection
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- The Journal of infectious diseases, vol 212, iss 11
- Accession number :
- edsair.od.......325..2f7417b183215745862d6d1480877c67