Association between human immunodeficiency virus-1 ribonucleic acid load in cerebrospinal fluid and central neurological diseases_West China Medical Journal

Authors：

ZHOU Ruifeng , WANG Yin , CHENG Dianxia , BI Lei , WU Xiaoli ,  CAI Lin

Department of Infectious Diseases, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610066, P. R. China;

Corresponding author：

CAI Lin, Email: 13981923195@163.com

Keywords：

Acquire immunodeficiency syndrome; central neurological diseases; human immunodeficiency virus-1 ribonucleic acid loads in cerebrospinal fluid

DOI：

10.7507/1002-0179.202003019

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4⁺ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4⁺ T lymphocyte count<200 cells/mm³ were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.

Citation： ZHOU Ruifeng, WANG Yin, CHENG Dianxia, BI Lei, WU Xiaoli, CAI Lin. Association between human immunodeficiency virus-1 ribonucleic acid load in cerebrospinal fluid and central neurological diseases. West China Medical Journal, 2022, 37(4): 537-541. doi: 10.7507/1002-0179.202003019 Copy

1.	Tyler KL, McArthur JC. Through a glass, darkly: cerebrospinal fluid viral load measurements and the pathogenesis of human immunodeficiency virus infection of the central nervous system. Arch Neurol, 2002, 59(6): 909-912.
2.	Heaton RK, Clifford DB, Franklin DR Jr, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER study. Neurology, 2010, 75(23): 2087-2096.
3.	王江蓉, 孙建军, 沈银忠, 等. 初治 HIV 感染者病毒载量水平及影响因素分析. 中国艾滋病性病, 2020, 26(9): 921-924.
4.	McMillan JM, Krentz H, Gill MJ, et al. Managing HIV infection in patients older than 50 years. CMAJ, 2018, 190(42): E1253-E1258.
5.	中华医学会感染病学分会艾滋病丙肝学组, 中国疾病预防与控制中心. 中国艾滋病诊疗指南(2018 版). 中国艾滋病性病, 2018, 24(12): 1266-1282.
6.	Morris L, Silber E, Sonnenberg P, et al. High human immunodeficiency virus type 1 RNA load in the cerebrospinal fluid from patients with lymphocytic meningitis. J Infect Dis, 1998, 177(2): 473-476.
7.	Brew BJ, Pemberton L, Cunningham P, et al. Levels of human immunodeficiency virus type 1 RNA in cerebrospinal fluid correlate with AIDS dementia stage. J Infect Dis, 1997, 175(4): 963-966.
8.	Cinque P, Bestetti A, Morelli P, et al. Molecular analysis of cerebrospinal fluid: potential for the study of HIV-1 infection of the central nervous system. J Neurovirol, 2000, 6(Suppl 1): S95-S102.
9.	吴亮, 王芳, 梁洪远, 等. AIDS 病人脑脊液与血液 HIV RNA 病毒载量相关性及影响因素. 中国艾滋病性病, 2017, 23(10): 883-886.
10.	Lederman MM, Georges DL, Kusner DJ, et al. Mycobacterium tuberculosis and its purified protein derivative activate expression of the human immunodeficiency virus. J Acquir Immune Defici Syndr, 1994, 7(7): 727-733.
11.	De Cock KM, Soro B, Coulibaly IM, et al. Tuberculosis and HIV infection in sub-Saharan Africa. JAMA, 1992, 268(12): 1581-1587.
12.	Seipone ID, Singh R, Patel VB, et al. Tuberculous meningitis is associated with higher cerebrospinal HIV-1 viral loads compared to other HIV-1-associated meningitides. PLoS One, 2018, 13(2): e0192060.
13.	Enose-Akahata Y, Azodi S, Smith BR, et al. Immunophenotypic characterization of CSF B cells in virus-associated neuroinflammatory diseases. PLoS Pathog, 2018, 14(4): e1007042.
14.	Patton SM, Wang Q, Hulgan T, et al. Cerebrospinal fluid (CSF) biomarkers of iron status are associated with CSF viral load, antiretroviral therapy, and demographic factors in HIV-infected adults. Fluids Barriers CNS, 2017, 14(1): 11.
15.	Zipeto D, Serena M, Mutascio S, et al. HIV-1-associated neurocognitive disorders: is HLA-C binding stability to β₂-microglobulin a missing piece of the pathogenetic puzzle?. Front Neurol, 2018(9): 791.

1. Tyler KL, McArthur JC. Through a glass, darkly: cerebrospinal fluid viral load measurements and the pathogenesis of human immunodeficiency virus infection of the central nervous system. Arch Neurol, 2002, 59(6): 909-912.
2. Heaton RK, Clifford DB, Franklin DR Jr, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER study. Neurology, 2010, 75(23): 2087-2096.
3. 王江蓉, 孙建军, 沈银忠, 等. 初治 HIV 感染者病毒载量水平及影响因素分析. 中国艾滋病性病, 2020, 26(9): 921-924.
4. McMillan JM, Krentz H, Gill MJ, et al. Managing HIV infection in patients older than 50 years. CMAJ, 2018, 190(42): E1253-E1258.
5. 中华医学会感染病学分会艾滋病丙肝学组, 中国疾病预防与控制中心. 中国艾滋病诊疗指南(2018 版). 中国艾滋病性病, 2018, 24(12): 1266-1282.
6. Morris L, Silber E, Sonnenberg P, et al. High human immunodeficiency virus type 1 RNA load in the cerebrospinal fluid from patients with lymphocytic meningitis. J Infect Dis, 1998, 177(2): 473-476.
7. Brew BJ, Pemberton L, Cunningham P, et al. Levels of human immunodeficiency virus type 1 RNA in cerebrospinal fluid correlate with AIDS dementia stage. J Infect Dis, 1997, 175(4): 963-966.
8. Cinque P, Bestetti A, Morelli P, et al. Molecular analysis of cerebrospinal fluid: potential for the study of HIV-1 infection of the central nervous system. J Neurovirol, 2000, 6(Suppl 1): S95-S102.
9. 吴亮, 王芳, 梁洪远, 等. AIDS 病人脑脊液与血液 HIV RNA 病毒载量相关性及影响因素. 中国艾滋病性病, 2017, 23(10): 883-886.
10. Lederman MM, Georges DL, Kusner DJ, et al. Mycobacterium tuberculosis and its purified protein derivative activate expression of the human immunodeficiency virus. J Acquir Immune Defici Syndr, 1994, 7(7): 727-733.
11. De Cock KM, Soro B, Coulibaly IM, et al. Tuberculosis and HIV infection in sub-Saharan Africa. JAMA, 1992, 268(12): 1581-1587.
12. Seipone ID, Singh R, Patel VB, et al. Tuberculous meningitis is associated with higher cerebrospinal HIV-1 viral loads compared to other HIV-1-associated meningitides. PLoS One, 2018, 13(2): e0192060.
13. Enose-Akahata Y, Azodi S, Smith BR, et al. Immunophenotypic characterization of CSF B cells in virus-associated neuroinflammatory diseases. PLoS Pathog, 2018, 14(4): e1007042.
14. Patton SM, Wang Q, Hulgan T, et al. Cerebrospinal fluid (CSF) biomarkers of iron status are associated with CSF viral load, antiretroviral therapy, and demographic factors in HIV-infected adults. Fluids Barriers CNS, 2017, 14(1): 11.
15. Zipeto D, Serena M, Mutascio S, et al. HIV-1-associated neurocognitive disorders: is HLA-C binding stability to β₂-microglobulin a missing piece of the pathogenetic puzzle?. Front Neurol, 2018(9): 791.

West China Medical Journal

Association between human immunodeficiency virus-1 ribonucleic acid load in cerebrospinal fluid and central neurological diseases

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