ArticleThe Journal of clinical investigation2024
Neurosymptomatic HIV-1 CSF escape is associated with replication in CNS T cells and inflammation.
Article in The Journal of clinical investigation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- HIV expression persists in the cerebrospinal fluid of HIV-associated neurocognitive disorders despite effective ART.Emerging microbes & infections · 2026Article
- Persistent low-level viremia and symptomatic HIV cerebrospinal fluid escape in a person living with HIV receiving darunavir: a case report.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases · 2026Article
- HIV Reservoirs in Brain parenchyma and Cerebrospinal Fluid During Suppressive ART: Same-Same or Very Different?Current HIV/AIDS reports · 2026Review
- Central Nervous System T-cell immune architecture, and not HIV burden, tracks with cognition under long-term viral suppression.PLoS pathogens · 2026Article
- Central Nervous System HIV Persistence and Clinical Consequences During Suppressive ART.Current HIV/AIDS reports · 2026Review
- Microglial reactivity and nodule formation are associated with Synaptodendritic damage in the brains of people with HIV-1.Brain pathology (Zurich, Switzerland) · 2026Article
- Neuroinflammatory crosstalk between microglia and astrocytes increases viral replication in an iPSC-derived model of CNS HIV infection.Scientific reports · 2026Article
- Elevated sCD14 in cerebrospinal fluid: a surrogate marker for HIV-associated neurocognitive disorders in Brazil.AIDS (London, England) · 2026Article
- Neurosymptomatic Cerebrospinal Fluid Escape Is a Central Nervous System-Focused Form of Antiretroviral Therapy Treatment Failure.Open forum infectious diseases · 2026Article
- Targeting HIV myeloid and central nervous system reservoirs for HIV cure.Current opinion in HIV and AIDS · 2025Review
- Neuroinflammatory crosstalk between microglia and astrocytes increases viral replication in an iPSC-derived model of CNS HIV infection.bioRxiv : the preprint server for biology · 2025Article
- Update on neurological complications of HIV.Current opinion in HIV and AIDS · 2025Review
- HIV Cerebrospinal Fluid Escape: Interventions for the Management, Current Evidence and Future Perspectives.Tropical medicine and infectious disease · 2025Review
- Pathogenic characteristics of central nervous system infections in AIDS individuals: a retrospective cohort study based on immune status.Frontiers in neurologyArticle
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Authors and funding
11 authors.
Funding
Abstract
During antiretroviral therapy (ART), most people living with HIV-1 have undetectable HIV-1 RNA in their plasma. However, they occasionally present with new or progressive neurologic deficits and detectable HIV-1 RNA in the cerebrospinal fluid (CSF), a condition defined as neurosymptomatic HIV-1 CSF escape (NSE). We explored the source of neuropathogenesis and HIV-1 RNA in the CSF during NSE by characterizing HIV-1 populations and inflammatory biomarkers in CSF from 25 individuals with NSE. HIV-1 populations in the CSF were uniformly drug resistant and adapted to replication in CD4+ T cells, but differed greatly in genetic diversity, with some having low levels of diversity similar to those observed during untreated primary infection and others having high levels like those during untreated chronic infection. Higher diversity in the CSF during NSE was associated with greater CNS inflammation. Finally, optimization of ART regimen was associated with viral suppression and improvement of neurologic symptoms. These results are consistent with CNS inflammation and neurologic injury during NSE being driven by replication of partially drug-resistant virus in CNS CD4+ T cells. This is unlike nonsuppressible viremia in the plasma during ART, which typically lacks clinical consequences and is generated by virus expression without replication.
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