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Better Biomarkers Are Needed to Improve the Management of the Neurologic Complications of HIV Infection

Year: 2008

Type: article

Abstract: To the Editor—Jenny-Avital et al. [1] raise important questions about investigations of human immunodeficiency virus (HIV) RNA levels in CSF. Most earlier studies of CSF HIV RNA levels have focused on HIV-associated neurocognitive disorder (HAND), because it is more prevalent in developed countries (where it occurs in up to one-half of HIV-infected individuals) than are neurologic opportunistic infections (NOIs), such as infections due to Cryptococcus species, Toxoplasma species, or JC virus. As pointed out by the correspondents, HAND and NOIs can occur concurrently. When NOIs are present, they can disturb the relationship between HIV and the brain. For example, non-HIV neurotropic pathogens can infect or injure neural cells, worsen neuroinflammation, and alter the permeability of the blood-brain and blood-CSF barriers. For these reasons and others, most earlier studies of the impact of HIV infection on the brain have excluded people who had active NOIs. We also excluded people who had active NOIs from our recent study to clearly link reductions in CSF HIV RNA levels to treatment with lopinavir-ritonavir [2].

Source: Clinical Infectious Diseases

DOI: 10.1086/588556

Authors: Scott L. Letendre, J. Allen McCutchan, Ronald J. Ellis

Institution: University of California San Diego

Language: English

Topic: HIV Research and Treatment

Subfield: Virology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: University of California, San Diego