2024
Neurosymptomatic HIV-1 CSF escape is associated with replication in CNS T cells and inflammation
Kincer L, Dravid A, Trunfio M, Calcagno A, Zhou S, Vercesi R, Spudich S, Gisslen M, Price R, Cinque P, Joseph S. Neurosymptomatic HIV-1 CSF escape is associated with replication in CNS T cells and inflammation. Journal Of Clinical Investigation 2024, 134: e176358. PMID: 39352388, PMCID: PMC11444166, DOI: 10.1172/jci176358.Peer-Reviewed Original ResearchConceptsHIV-1 RNACD4+ T cellsHIV-1 populationsAntiretroviral therapyHIV-1T cellsCerebrospinal fluidCSF escapeCNS inflammationDetectable HIV-1 RNAImprovement of neurological symptomsAssociated with viral suppressionUntreated chronic infectionDrug-resistant virusesProgressive neurological deficitsCNS T cellsART regimenViral suppressionChronic infectionNeurological deficitsNeurological symptomsInflammatory biomarkersClinical consequencesVirus expressionPrimary infectionChanges in cerebrospinal fluid proteins across the spectrum of untreated and treated chronic HIV-1 infection
Hu Z, Cinque P, Dravid A, Hagberg L, Yilmaz A, Zetterberg H, Fuchs D, Gostner J, Blennow K, Spudich S, Kincer L, Zhou S, Joseph S, Swanstrom R, Price R, Gisslén M. Changes in cerebrospinal fluid proteins across the spectrum of untreated and treated chronic HIV-1 infection. PLOS Pathogens 2024, 20: e1012470. PMID: 39316609, PMCID: PMC11469498, DOI: 10.1371/journal.ppat.1012470.Peer-Reviewed Original ResearchConceptsHIV-1 infectionHIV-associated dementiaCerebrospinal fluidCerebrospinal fluid proteinCerebrospinal fluid HIV-1 RNAImpact of HIV-1 infectionTreating chronic HIV-1 infectionChronic HIV-1 infectionHIV-1 RNAHIV-1 progressionTreat chronic infectionsInflammatory cell lineagesNeurofilament light chain proteinCSF escapeChronic infectionHIV-1Light chain proteinProtein changesClinical centersCNS injuryCSF proteinClinical informationCell lineagesInfectionCerebrospinal fluid proteome
2021
VZV myelitis with secondary HIV CSF escape
Weiss JJ, Spudich S, Barakat L. VZV myelitis with secondary HIV CSF escape. BMJ Case Reports 2021, 14: e241738. PMID: 34187795, PMCID: PMC8245447, DOI: 10.1136/bcr-2021-241738.Peer-Reviewed Case Reports and Technical NotesConceptsVaricella-zoster virusCSF escapeVZV myelitisSkin lesionsCerebrospinal fluidCSF HIV viral loadRight upper extremity weaknessCentral nervous system infectionSubsequent oral therapyUpper extremity weaknessHIV viral loadNervous system infectionVesicular skin lesionsCopies/mLDirect fluorescent antibody testingFluorescent antibody testingIntravenous acyclovirVZV PCRExtremity weaknessOral therapyRare complicationSystem infectionAtypical presentationImmunosuppressed patientsVZV infection
2020
Minimal detection of cerebrospinal fluid escape after initiation of antiretroviral therapy in acute HIV-1 infection.
Handoko R, Chan P, Jagodzinski L, Pinyakorn S, Ubolyam S, Phanuphak N, Sacdalan C, Kroon E, Dumrongpisutikul N, Paul R, Valcour V, Ananworanich J, Vasan S, Spudich S. Minimal detection of cerebrospinal fluid escape after initiation of antiretroviral therapy in acute HIV-1 infection. AIDS 2020, 35: 777-782. PMID: 33306551, PMCID: PMC7969409, DOI: 10.1097/qad.0000000000002786.Peer-Reviewed Original ResearchConceptsAcute HIV-1 infectionHIV-1 RNACentral nervous systemCSF escapeAntiretroviral therapyHIV-1 infectionWeek 96Week 24HIV-1CSF HIV-1 RNAInitiation of ARTLong-term neurological outcomePlasma HIV-1 RNAWeeks of ARTProspective cohort studyPersistence of HIVHIV-1 persistenceLevels of CSFYears of treatmentHIV-1 replicationNeurological outcomeCohort studyVoluntary counselingChronic infectionEarly treatment
2018
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
Joseph SB, Kincer LP, Bowman NM, Evans C, Vinikoor MJ, Lippincott CK, Gisslén M, Spudich S, Menezes P, Robertson K, Archin N, Kashuba A, Eron JJ, Price RW, Swanstrom R. 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. Clinical Infectious Diseases 2018, 69: 1345-1352. PMID: 30561541, PMCID: PMC6938202, DOI: 10.1093/cid/ciy1066.Peer-Reviewed Original ResearchConceptsCentral nervous systemHIV-1 RNA concentrationsAntiretroviral therapySuppressive antiretroviral therapyCerebrospinal fluidCNS reservoirsCSF escapeCSF HIV-1 RNA concentrationsCentral nervous system reservoirYears of ARTHuman immunodeficiency virus type 1 (HIV-1) populationHuman immunodeficiency virus type 1 (HIV-1) RNAStable antiretroviral therapyHIV-1 RNAMacrophages/microgliaInfected T cellsRNA concentrationViral envelope sequencesType 1 populationViral populationsViral suppressionMacrophage-tropicAsymptomatic participantsMultiple time pointsT cells
2012
Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load
Peluso MJ, Ferretti F, Peterson J, Lee E, Fuchs D, Boschini A, Gisslén M, Angoff N, Price RW, Cinque P, Spudich S. Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. AIDS 2012, 26: 1765-1774. PMID: 22614889, PMCID: PMC3881435, DOI: 10.1097/qad.0b013e328355e6b2.Peer-Reviewed Original ResearchConceptsCSF HIV RNAAntiretroviral therapyHIV RNACopies/CSF escapeNeurologic abnormalitiesCerebrospinal fluidMedian CD4 T-cell countDetectable CSF HIV RNAMedian plasma HIV RNACD4 T-cell countCentral nervous system exposureNew neurologic abnormalitiesPlasma HIV levelsPlasma HIV RNAProgressive neurologic abnormalitiesStable ART regimenPlasma viral loadT-cell countsElevated CSF proteinRetrospective case seriesProgressive neurologic dysfunctionUrban medical centerCSF RNAHIV escape
2010
HIV-1 Viral Escape in Cerebrospinal Fluid of Subjects on Suppressive Antiretroviral Treatment
Edén A, Fuchs D, Hagberg L, Nilsson S, Spudich S, Svennerholm B, Price RW, Gisslén M. HIV-1 Viral Escape in Cerebrospinal Fluid of Subjects on Suppressive Antiretroviral Treatment. The Journal Of Infectious Diseases 2010, 202: 1819-1825. PMID: 21050119, PMCID: PMC3052942, DOI: 10.1086/657342.Peer-Reviewed Original ResearchConceptsHIV-1 RNAAntiretroviral therapy regimensCerebrospinal fluidViral escapeTherapy regimensPlasma human immunodeficiency virus type 1 (HIV-1) RNACSF HIV-1 RNAHuman immunodeficiency virus type 1 (HIV-1) RNACentral nervous system infectionCSF neopterin levelsCSF viral escapeHigher CSF neopterinIntrathecal immune activationPrevious treatment interruptionsSuppressive antiretroviral treatmentAtazanavir/ritonavirLopinavir/ritonavirNervous system infectionCSF virusNew treatment combinationsCopies/mLEnzyme-linked immunosorbentPolymerase chain reaction assaysCSF escapeCSF neopterin