ArticleAIDS research and therapy2010
Cerebrospinal fluid neopterin: an informative biomarker of central nervous system immune activation in HIV-1 infection.
Article in AIDS research and therapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 138 papers, 1 of them a synthesis that pooled it.
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Who cites it
138 citing papers in PubMed, 1 synthesis or guideline pooled it, 212 citations in OpenAlex.
- Sex Differences in Neurocognitive Function in Adults with HIV: Patterns, Predictors, and Mechanisms.Current psychiatry reports · 2019Pooled it
- Longitudinal changes in plasma biomarkers of immune activation, neuronal inflammation and injury in persons with HIV initiating ART.HIV medicine · 2026Trial
- Antiretroviral Therapy Intensification for Neurocognitive Impairment in Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Limited correlation between systemic biomarkers and neurocognitive performance before and during HIV treatment.Journal of neurovirology · 2020Trial
- Predicting Efavirenz Concentrations in the Brain Tissue of HIV-Infected Individuals and Exploring their Relationship to Neurocognitive Impairment.Clinical and translational science · 2019Trial
- Normalization of Soluble CD163 Levels After Institution of Antiretroviral Therapy During Acute HIV Infection Tracks with Fewer Neurological Abnormalities.The Journal of infectious diseases · 2018Trial
- Improved Cognitive Performance and Reduced Monocyte Activation in Virally Suppressed Chronic HIV After Dual CCR2 and CCR5 Antagonism.Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- CSF inflammatory markers and neurocognitive function after addition of maraviroc to monotherapy darunavir/ritonavir in stable HIV patients: the CINAMMON study.Journal of neurovirology · 2018Trial
- Effect of protein binding on unbound atazanavir and darunavir cerebrospinal fluid concentrations.Journal of clinical pharmacology · 2014Trial
- Raltegravir treatment intensification does not alter cerebrospinal fluid HIV-1 infection or immunoactivation in subjects on suppressive therapy.The Journal of infectious diseases · 2011Trial
- Plasma NfL and sCD14 Are Associated with Polypharmacy and Recurrent Falls in Virally Suppressed Older People with HIV.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Elevated peripheral and nervous system inflammation is associated with decreased short-chain fatty acid levels in Zika virus-infected macaques.Journal of virology · 2025Article
- Prospective Neuropsychological and Plasma Biomarker Changes in Treatment-Naïve People Living with HIV After Antiretroviral Treatment Initiation.Biomedicines · 2025Article
- Neuropathogenesis of acute HIV: mechanisms, biomarkers, and therapeutic approaches.Current opinion in HIV and AIDS · 2025Review
- Asymptomatic Cerebrospinal Fluid HIV-1 Escape: Incidence and Consequences.The Journal of infectious diseases · 2025Article
- Changes in cerebrospinal fluid proteins across the spectrum of untreated and treated chronic HIV-1 infection.PLoS pathogens · 2024Article
- CSF Neopterin Levels Are Elevated in Various Neurological Diseases and Aging.Journal of clinical medicine · 2024Article
- Multimodal Approach to Neurocognitive Function in People Living with HIV in the cART Era: A Comprehensive Review.Life (Basel, Switzerland) · 2024Review
- HIV-1-infected T cell clones are shared across cerebrospinal fluid and blood during ART.JCI insight · 2024Article
- Serum Neopterin, Biopterin, Tryptophan, and Kynurenine Levels in Patients with Fabry DiseaseBalkan medical journal · 2024Article
78 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
HIV-1 invades the central nervous system (CNS) in the context of acute infection, persists thereafter in the absence of treatment, and leads to chronic intrathecal immunoactivation that can be measured by the macrophage activation marker, neopterin, in cerebrospinal fluid (CSF). In this review we describe our experience with CSF neopterin measurements in 382 untreated HIV-infected patients across the spectrum of immunosuppression and HIV-related neurological diseases, in 73 untreated AIDS patients with opportunistic CNS infections, and in 233 treated patients.In untreated patients, CSF neopterin concentrations are almost always elevated and increase progressively as immunosuppression worsens and blood CD4 cell counts fall. However, patients with HIV dementia exhibit particularly high CSF neopterin concentrations, above those of patients without neurological disease, though patients with CNS opportunistic infections, including CMV encephalitis and cryptococcal meningitis, also exhibit high levels of CSF neopterin. Combination antiretroviral therapy, with its potent effect on CNS HIV infection and CSF HIV RNA, mitigates both intrathecal immunoactivation and lowers CSF neopterin. However, despite suppression of plasma and CSF HIV RNA to below the detection limits of clinical assays (<50 copies HIV RNA/mL), CSF neopterin often remains mildly elevated, indicating persistent low-level intrathecal immune activation and raising the important questions of whether this elevation is driven by continued CNS infection and whether it causes continued indolent CNS injury.Although nonspecific, CSF neopterin can serve as a useful biomarker in the diagnosis of HIV dementia in the setting of confounding conditions, in monitoring the CNS inflammatory effects of antiretroviral treatment, and give valuable information to the cause of ongoing brain injury.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.