OBJECTIVE: To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART). METHODS: Cross-sectional and longitudinal analysis of HIV RNA, proinflammatory cytokines (IL-6, IL-10, INF-γ, TNF-α, TGF-β1, and TGF-β2) and chemokines (MIP-1α, MIP-1β, and MCP-1) in plasma and cerebrospinal fluid (CSF) of HIV-infected patients with CD4 <200/μL. RESULTS: HAND was diagnosed at baseline in 6/12 patients. Baseline CSF HIV-RNA was comparable in patients with or without HAND, whereas CSF concentration of IL-6 and MIP-1β, proinflammatory cytokines, was increased in HAND patients. CSF evaluation at 12 weeks was available in 10/12 cases. ART greatly reduced HIV-RNA in all patients. Nevertheless, IL-6 and MIP-1β remained elevated after 12 weeks of therapy in HAND patients, in whom CSF HIV RNA decay was slower than the plasmatic one as well. CONCLUSION: Immune activation, as indicated by inflammatory cytokines, but not higher levels of HIV-RNA is observed in advanced naïve HIV-infected patients with HAND. In HAND patients, ART introduction resulted in a less rapid clearance of CSF viremia compared to plasma and no modifications of intratechal immune activation
Neurocognitive impairment in HIV-infected naive patients with advanced disease: the role of virus and intrathecal immune activation / M. Airoldi, A. Bandera, D. Trabattoni, B. Tagliabue, B. Arosio, A. Soria, V. Rainone, G. Lapadula, G. Annoni, M. Clerici, A. Gori. - In: CLINICAL & DEVELOPMENTAL IMMUNOLOGY. - ISSN 1740-2522. - 2012(2012), pp. 467154.1-467154.5.
|Titolo:||Neurocognitive impairment in HIV-infected naive patients with advanced disease: the role of virus and intrathecal immune activation|
|Settore Scientifico Disciplinare:||Settore MED/04 - Patologia Generale|
Settore MED/17 - Malattie Infettive
|Data di pubblicazione:||2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1155/2012/467154|
|Appare nelle tipologie:||01 - Articolo su periodico|