Infectious Diseases Department, Infectious Diseases Hospital "Francisco J Muñiz", Buenos Aires, Argentina.
J Int AIDS Soc. 2009 Nov 11;12:33. doi: 10.1186/1758-2652-12-33.
The central nervous system is considered a sanctuary site for HIV-1 replication. Variables associated with HIV cerebrospinal fluid (CSF) viral load in the context of opportunistic CNS infections are poorly understood. Our objective was to evaluate the relation between: (1) CSF HIV-1 viral load and CSF cytological and biochemical characteristics (leukocyte count, protein concentration, cryptococcal antigen titer); (2) CSF HIV-1 viral load and HIV-1 plasma viral load; and (3) CSF leukocyte count and the peripheral blood CD4+ T lymphocyte count.
Our approach was to use a prospective collection and analysis of pre-treatment, paired CSF and plasma samples from antiretroviral-naive HIV-positive patients with cryptococcal meningitis and assisted at the Francisco J Muñiz Hospital, Buenos Aires, Argentina (period: 2004 to 2006). We measured HIV CSF and plasma levels by polymerase chain reaction using the Cobas Amplicor HIV-1 Monitor Test version 1.5 (Roche). Data were processed with Statistix 7.0 software (linear regression analysis).
Samples from 34 patients were analyzed. CSF leukocyte count showed statistically significant correlation with CSF HIV-1 viral load (r = 0.4, 95% CI = 0.13-0.63, p = 0.01). No correlation was found with the plasma viral load, CSF protein concentration and cryptococcal antigen titer. A positive correlation was found between peripheral blood CD4+ T lymphocyte count and the CSF leukocyte count (r = 0.44, 95% CI = 0.125-0.674, p = 0.0123).
Our study suggests that CSF leukocyte count influences CSF HIV-1 viral load in patients with meningitis caused by Cryptococcus neoformans.
中枢神经系统被认为是 HIV-1 复制的避难所。在机会性中枢神经系统感染的情况下，与 HIV 脑脊液（CSF）病毒载量相关的变量尚未得到很好的理解。我们的目的是评估以下三者之间的关系：（1）CSF HIV-1 病毒载量与 CSF 细胞学和生化特征（白细胞计数、蛋白浓度、隐球菌抗原滴度）；（2）CSF HIV-1 病毒载量与 HIV-1 血浆病毒载量；（3）CSF 白细胞计数与外周血 CD4+T 淋巴细胞计数。
我们采用前瞻性收集和分析方法，对来自阿根廷布宜诺斯艾利斯弗朗西斯科 J·穆尼兹医院的未经抗逆转录病毒治疗的 HIV 阳性、新型隐球菌性脑膜炎患者的治疗前配对 CSF 和血浆样本进行分析（时间：2004 年至 2006 年）。我们使用罗氏 Cobas Amplicor HIV-1 Monitor Test 版本 1.5（聚合酶链反应）测量 HIV CSF 和血浆水平。使用 Statistix 7.0 软件（线性回归分析）处理数据。
共分析了 34 例患者的样本。CSF 白细胞计数与 CSF HIV-1 病毒载量呈统计学显著相关（r = 0.4，95%置信区间= 0.13-0.63，p = 0.01）。与血浆病毒载量、CSF 蛋白浓度和隐球菌抗原滴度无相关性。外周血 CD4+T 淋巴细胞计数与 CSF 白细胞计数呈正相关（r = 0.44，95%置信区间= 0.125-0.674，p = 0.0123）。
我们的研究表明，新型隐球菌性脑膜炎患者的 CSF 白细胞计数会影响 CSF HIV-1 病毒载量。
