Document Detail


Single-copy assay quantification of HIV-1 RNA in paired cerebrospinal fluid and plasma samples from elite controllers.
MedLine Citation:
PMID:  23211774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Elite controllers are a rare subset of HIV-1-infected individuals who maintain HIV-1 RNA concentrations in plasma below the lower limit of quantification of clinical assays (<20-50 copies/ml) in the absence of antiretroviral therapy. Here, we examine to what extent elite controllers also control infection of the central nervous system (CNS).
DESIGN: We analysed paired cerebrospinal fluid (CSF) and plasma samples using a highly sensitive assay for HIV-1 RNA quantification.
METHODS: We analysed 28 CSF samples and 27 concurrent plasma samples from 14 elite controllers with the highly sensitive single-copy assay (SCA) that allows for HIV-1 RNA quantification down to less than one copy of HIV-1 RNA per millilitre.
RESULTS: Three samples were excluded because of internal standard failure. HIV-1 RNA was detected in only five of 26 CSF samples compared with 14 of 26 plasma samples (P = 0.02), with a median of 0.2 (range, 0.1-6) copies/ml in CSF compared with 0.8 (range, 0.1-189 copies/ml) in plasma (P < 0.0001).
CONCLUSION: HIV-1 RNA could not be detected in CSF in most elite controllers using the highly sensitive SCA, and when detected, it was at significantly lower frequencies and concentrations than in plasma. Elite controllers thus control HIV-1 in the CNS very well. Whether the infrequent and small amounts of HIV-1 RNA in the CSF reflect production from a local reservoir or virion exchange between the blood and the CSF is uncertain.
Authors:
Viktor Dahl; Julia Peterson; Serena Spudich; Evelyn Lee; Barbara L Shacklett; Richard W Price; Sarah Palmer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  27     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-08-01     Completed Date:  2013-11-12     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  1145-9     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / blood,  cerebrospinal fluid,  immunology*
Adult
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes
CD8-Positive T-Lymphocytes
Central Nervous System Viral Diseases / blood,  cerebrospinal fluid,  immunology*
Female
HIV Infections / blood,  cerebrospinal fluid,  immunology*
HIV-1 / genetics*,  immunology
Humans
Immunity, Innate
Male
Middle Aged
RNA, Viral / blood,  cerebrospinal fluid,  immunology*
Viral Load
Virion / immunology
Grant Support
ID/Acronym/Agency:
R01 MH081772/MH/NIMH NIH HHS; R01MH081772/MH/NIMH NIH HHS; R21 MH096619/MH/NIMH NIH HHS; R21 NS069219/NS/NINDS NIH HHS; R21MH096619/MH/NIMH NIH HHS; R21NS069219/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/RNA, Viral
Comments/Corrections

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