Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
AIDS. 2010 Apr 24;24(7):1001-5. doi: 10.1097/QAD.0b013e328331e15b.
A subset of HIV-infected patients, termed 'elite' viral controllers, maintain undetectable plasma HIV RNA levels in the absence of therapy. In this group, host-mediated viral control may be accompanied by chronic systemic inflammation. It is unknown whether either infection or chronic inflammation is present within the central nervous system of these individuals.
Cross-sectional analysis compared cerebrospinal fluid (CSF) HIV RNA and biomarkers of intrathecal inflammation in eight controllers (plasma HIV RNA levels <50 copies/ml) with 26 HIV-uninfected individuals, 25 untreated individuals HIV-infected, viremic individuals, and 23 HIV-infected individuals with treatment-mediated viral suppression (plasma HIV RNA levels <50 copies/ml).
All controllers had CSF HIV RNA levels below 2.5 copies/ml. CSF white blood cell (WBC) counts and CSF: plasma albumin ratios in the controllers were similar to those in both HIV-uninfected individuals and antiretroviral therapy-suppressed HIV-infected individuals. CSF neopterin, MCP-1, and IP-10 concentrations were also not different in the controllers from either HIV-uninfected or treated HIV-infected individuals.
The character of CSF HIV infection and degree of immunoactivation in controllers is comparable to that of HIV-uninfected and antiretroviral therapy-suppressed HIV-infected individuals, but distinct from that of untreated, viremic HIV-infected individuals.
在未经治疗的情况下，HIV 感染者中存在一部分被称为“精英”病毒控制器的患者，其血浆 HIV RNA 水平无法检测到。在这个群体中，宿主介导的病毒控制可能伴随着慢性全身炎症。目前尚不清楚这些个体的中枢神经系统中是否存在感染或慢性炎症。
采用横断面分析比较了 8 名病毒控制器（血浆 HIV RNA 水平<50 拷贝/ml）、26 名 HIV 未感染者、25 名未经治疗的 HIV 感染者、病毒血症患者和 23 名经治疗病毒抑制（血浆 HIV RNA 水平<50 拷贝/ml）的 HIV 感染者的脑脊液（CSF）HIV RNA 和鞘内炎症生物标志物。
所有控制器的 CSF HIV RNA 水平均低于 2.5 拷贝/ml。控制器的 CSF 白细胞（WBC）计数和 CSF：血浆白蛋白比值与 HIV 未感染者和接受抗逆转录病毒治疗抑制 HIV 感染者相似。CSF 新蝶呤、MCP-1 和 IP-10 浓度在控制器中与 HIV 未感染者或接受治疗的 HIV 感染者也没有差异。
控制器 CSF 中的 HIV 感染特征和免疫激活程度与 HIV 未感染者和接受抗逆转录病毒治疗抑制 HIV 感染者相似，但与未经治疗、病毒血症的 HIV 感染者不同。
