ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Human Immunodeficiency Virus Type 1 RNA Detected in the Central Nervous System (CNS) After Years of Suppressive Antiretroviral Therapy Can Originate from a Replicating CNS Reservoir or Clonally Expanded Cells.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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61 citing papers in PubMed, 82 citations in OpenAlex.
- Brief Report: Rebound HIV Viremia With Meningoencephalitis After Antiretroviral Therapy Interruption After Allogeneic Bone Marrow Transplant.Journal of acquired immune deficiency syndromes (1999) · 2022Trial
- Cerebrospinal Fluid Findings in Asymptomatic Adolescents on Long-term Antiretroviral Therapy After Perinatally Acquired HIV: An Exploratory Cross-sectional Study.Open forum infectious diseases · 2026Article
- HIV-1 compartmentalization in the central nervous system during cryptococcal meningitis: Analysis of viral, fungal, and host factors.PLoS pathogens · 2026Article
- ΔJournal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2026Article
- HIV Reservoirs in Brain parenchyma and Cerebrospinal Fluid During Suppressive ART: Same-Same or Very Different?Current HIV/AIDS reports · 2026Review
- A New Type of Nonsuppressible Viremia Produced by HIV-Infected Macrophage.The Journal of infectious diseases · 2026Article
- HIV persistence in tissues on dolutegravir-based therapy is not associated with resistance mutations to dolutegravir.Communications medicine · 2026Article
- A New Type of Nonsuppressible Viremia Produced by HIV-Infected Macrophage.bioRxiv : the preprint server for biology · 2025Article
- Clonal heterogeneity and antigenic stimulation shape persistence of the latent reservoir of HIV.PLoS computational biology · 2025Article
- Involvement of lncRNAs NEAT1 and ZBTB11-AS1 in Active and Persistent HIV-1 Infection in C20 Human Microglial Cell Line.International journal of molecular sciences · 2025Article
- Article
- Asymptomatic Cerebrospinal Fluid HIV-1 Escape: Incidence and Consequences.The Journal of infectious diseases · 2025Article
- HIV Cerebrospinal Fluid Escape: Interventions for the Management, Current Evidence and Future Perspectives.Tropical medicine and infectious disease · 2025Review
- Longitudinal CNS and systemic T-lymphocyte and monocyte activation before and after antiretroviral therapy beginning in primary HIV infection.Frontiers in immunology · 2025Article
- High concordance of human immunodeficiency virus-1 genotypic drug resistance generated from paired cerebrospinal fluid and plasma in antiretroviral therapy -naive or -experienced patients.Frontiers in microbiology · 2025Article
- Neurosymptomatic HIV-1 CSF escape is associated with replication in CNS T cells and inflammation.The Journal of clinical investigation · 2024Article
- Gene expression and chromatin conformation of microglia in virally suppressed people with HIV.Life science alliance · 2024Article
- Changes in cerebrospinal fluid proteins across the spectrum of untreated and treated chronic HIV-1 infection.PLoS pathogens · 2024Article
- HIV-1-infected T cell clones are shared across cerebrospinal fluid and blood during ART.JCI insight · 2024Article
- Learning from cerebrospinal fluid drug-resistant HIV escape-associated encephalitis: a case report.Virology journal · 2023Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
15 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundHuman immunodeficiency virus type 1 (HIV-1) populations are detected in cerebrospinal fluid (CSF) of some people on suppressive antiretroviral therapy (ART). Detailed analysis of these populations may reveal whether they are produced by central nervous system (CNS) reservoirs.
methodsWe performed a study of 101 asymptomatic participants on stable ART. HIV-1 RNA concentrations were cross-sectionally measured in CSF and plasma. In participants with CSF HIV-1 RNA concentrations sufficient for analysis, viral populations were genetically and phenotypically characterized over multiple time points.
resultsFor 6% of participants (6 of 101), the concentration of HIV-1 RNA in their CSF was ≥0.5 log copies/mL above that of plasma (ie, CSF escape). We generated viral envelope sequences from CSF of 3 participants. One had a persistent CSF escape population that was macrophage-tropic, partially drug resistant, genetically diverse, and closely related to a minor macrophage-tropic lineage present in the blood prior to viral suppression and enriched for after ART. Two participants (1 suppressed and 1 not) had transient CSF escape populations that were R5 T cell-tropic with little genetic diversity.
conclusionsExtensive analysis of viral populations in 1 participant revealed that CSF escape was from a persistently replicating population, likely in macrophages/microglia, present in the CNS over 3 years of ART. CSF escape in 2 other participants was likely produced by trafficking and transient expansion of infected T cells in the CNS. Our results show that CNS reservoirs can persist during ART and that CSF escape is not exclusively produced by replicating CNS reservoirs.
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