Blood Brain Barrier Impairment in HIV-Positive Na ïve and Effectively Treated Patients: Immune Activation Versus Astrocytosis

AbstractBlood brain barrier (BBB) damage is a common feature in central nervous system infections by HIV and it may persist despite effective antiretroviral therapy. Astrocyte involvement has not been studied in this setting. Patients were enrolled in an ongoing prospective study and subjects with central nervous system-affecting disorders were excluded. Patients were divided into two groups: treated subjects with cerebrospinal fluid (CSF) HIV RNA<50 copies/mL (CSF-controllers) and in late-presenters CD4+ T lymphocytes<100/uL. CSF biomarkers of neuronal or astrocyte damage were measured and compared to CSF serum-to-albumin ratio. 134 patients were included; 67 subjects in each group (50  %) with similar demographic characteristics (with the exception of older age in CSF controllers). CD4 (cells/uL), plasma and CSF HIV RNA (Log10 copies/mL) were 43 (20-96), 5.6 (5.2-6) and 3.9 (3.2-4.7) in LPs and 439 (245-615),<1.69 (9 patients<2.6) and<1.69 in CSFc. BBB impairment was observed in 17 late-presenters (25.4  %) and in 9 CSF-controllers (13.4 %). CSF biomarkers were similar but for higher CSF neopterin values in late-presenters (2.3 vs. 0.6 ng/mL,p <  0.001). CSARs were associated with CSF neopterin (rho = 0.31,p = 0.03) and HIV RNA (rho = 0.24,p = 0.05) in late-presenters and with CSF tau (rho = 0.51,p <  0.001), p-tau (rho = 0.47,p <  0.001) and S100beta (rho = 0.33,p = 0.009) in CSF-controllers. In HAART-...
Source: Journal of NeuroImmune Pharmacology - Category: Drugs & Pharmacology Source Type: research