2023
Antiretroviral Therapy Intensification for Neurocognitive Impairment in Human Immunodeficiency Virus
Letendre S, Chen H, McKhann A, Roa J, Vecchio A, Daar E, Berzins B, Hunt P, Marra C, Campbell T, Coombs R, Ma Q, Swaminathan S, Macatangay B, Morse G, Miller T, Rusin D, Greninger A, Ha B, Alston-Smith B, Robertson K, Paul R, Spudich S, Team T. Antiretroviral Therapy Intensification for Neurocognitive Impairment in Human Immunodeficiency Virus. Clinical Infectious Diseases 2023, 77: 866-874. PMID: 37183889, PMCID: PMC10506779, DOI: 10.1093/cid/ciad265.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyART intensificationNeurocognitive impairmentWeek 48Z-scoreAntiretroviral therapy intensificationPersistent HIV replicationPlacebo-controlled trialPlasma HIV RNASuppressive antiretroviral therapyAge 52 yearsBody mass indexHuman immunodeficiency virusCopies/mLTotal Z-scoreBaseline z-scoresCentral nervous systemDual placeboEfavirenz useTherapy intensificationHIV RNAStudy drugAdverse eventsSymptomatic HIVPrimary outcome
2021
Cerebrospinal Fluid Viral Load Across the Spectrum of Untreated Human Immunodeficiency Virus Type 1 (HIV-1) Infection: A Cross-Sectional Multicenter Study
Ulfhammer G, Edén A, Antinori A, Brew BJ, Calcagno A, Cinque P, De Zan V, Hagberg L, Lin A, Nilsson S, Oprea C, Pinnetti C, Spudich S, Trunfio M, Winston A, Price RW, Gisslén M. Cerebrospinal Fluid Viral Load Across the Spectrum of Untreated Human Immunodeficiency Virus Type 1 (HIV-1) Infection: A Cross-Sectional Multicenter Study. Clinical Infectious Diseases 2021, 75: 493-502. PMID: 34747481, PMCID: PMC9427147, DOI: 10.1093/cid/ciab943.Peer-Reviewed Original ResearchConceptsCSF HIV RNAWhite blood cell countPlasma HIV RNAUntreated human immunodeficiency virus type 1 (HIV-1) infectionHuman immunodeficiency virus type 1 (HIV-1) infectionCSF white blood cell countVirus type 1 infectionHIV RNACopies/mLType 1 infectionMulticenter studyOpportunistic central nervous system infectionsCerebrospinal fluid HIV RNACerebrospinal fluid viral loadHigher CSF HIV RNALog10 copies/mLCentral nervous system infectionCross-sectional multicenter studyHIV RNA quantificationNervous system infectionTreatment-naive adultsBlood cell countLarge multicenter studyCNS compartmentalizationCSF discordanceVZV 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
Determinants of suboptimal CD4+ T cell recovery after antiretroviral therapy initiation in a prospective cohort of acute HIV‐1 infection
Handoko R, Colby DJ, Kroon E, Sacdalan C, de Souza M, Pinyakorn S, Prueksakaew P, Munkong C, Ubolyam S, Akapirat S, Chiarella J, Krebs S, Sereti I, Valcour V, Paul R, Michael NL, Phanuphak N, Ananworanich J, Spudich S, Team T. Determinants of suboptimal CD4+ T cell recovery after antiretroviral therapy initiation in a prospective cohort of acute HIV‐1 infection. Journal Of The International AIDS Society 2020, 23: e25585. PMID: 32949118, PMCID: PMC7507109, DOI: 10.1002/jia2.25585.Peer-Reviewed Original ResearchConceptsAcute HIV infectionCD4/CD8 ratioSuboptimal CD4 recoveryAntiretroviral therapyCD4 countImmune recoveryCD4 recoveryCD8 ratioStudy visitAcute HIV-1 infectionPre-ART CD4 countLower CD8 countsPlasma viral suppressionSuboptimal immune recoveryAntiretroviral therapy initiationT-cell countsT-cell recoveryHIV-1 infectionCopies/mLLower IL-6Cells/ART initiationCD4 rateCD8 countsChronic HIVA randomized trial of vorinostat with treatment interruption after initiating antiretroviral therapy during acute HIV-1 infection
Kroon EDMB, Ananworanich J, Pagliuzza A, Rhodes A, Phanuphak N, Trautmann L, Mitchell JL, Chintanaphol M, Intasan J, Pinyakorn S, Benjapornpong K, Chang JJ, Colby DJ, Chomchey N, Fletcher JLK, Eubanks K, Yang H, Kapson J, Dantanarayana A, Tennakoon S, Gorelick RJ, Maldarelli F, Robb ML, Kim JH, Spudich S, Chomont N, Phanuphak P, Lewin SR, de Souza MS, Teams F. A randomized trial of vorinostat with treatment interruption after initiating antiretroviral therapy during acute HIV-1 infection. Journal Of Virus Eradication 2020, 6: 100004. PMID: 33251022, PMCID: PMC7646672, DOI: 10.1016/j.jve.2020.100004.Peer-Reviewed Original ResearchAcute HIV infectionAntiretroviral therapyTreatment interruptionViral loadAcute HIV-1 infectionHIV RNA copies/Open-label pilot studyPeripheral blood mononuclear cellsControl HIV replicationSubsequent treatment interruptionTotal HIV DNASerious adverse eventsHIV viral loadPlasma viral loadRNA copies/HIV-1 infectionBlood mononuclear cellsCopies/mLProportion of participantsCell-associated RNAAlternative treatment strategiesHistone deacetylase inhibitorsVL reboundHIV RNAViral rebound
2018
Structural and functional brain imaging in acute HIV
Samboju V, Philippi CL, Chan P, Cobigo Y, Fletcher JLK, Robb M, Hellmuth J, Benjapornpong K, Dumrongpisutikul N, Pothisri M, Paul R, Ananworanich J, Spudich S, Valcour V, 010/RV254 S, teams R. Structural and functional brain imaging in acute HIV. NeuroImage Clinical 2018, 20: 327-335. PMID: 30101063, PMCID: PMC6082997, DOI: 10.1016/j.nicl.2018.07.024.Peer-Reviewed Original ResearchConceptsResting-state functional connectivityAcute HIV infectionAntiretroviral treatmentDiffusion tensor imagingAHI groupNPZ-4HIV RNARadial diffusivityFractional anisotropyCerebrospinal fluidHigher CD4 cell countsParahippocampal cortexHigher resting-state functional connectivityCombination antiretroviral treatmentHIV disease variablesLeft parahippocampal cortexMean CD4 countPlasma HIV RNACD4 cell countCopies/mLNeuropsychological testing performanceMicrostructural white matterFunctional brain integrityMiddle frontal gyrusSuperior longitudinal fasciculusDistribution of Human Immunodeficiency Virus (HIV) Ribonucleic Acid in Cerebrospinal Fluid and Blood Is Linked to CD4/CD8 Ratio During Acute HIV
Chan P, Patel P, Hellmuth J, Colby DJ, Kroon E, Sacdalan C, Pinyakorn S, Jagodzinski L, Krebs S, Ananworanich J, Valcour V, Spudich S, Team R. Distribution of Human Immunodeficiency Virus (HIV) Ribonucleic Acid in Cerebrospinal Fluid and Blood Is Linked to CD4/CD8 Ratio During Acute HIV. The Journal Of Infectious Diseases 2018, 218: 937-945. PMID: 29741638, PMCID: PMC6093332, DOI: 10.1093/infdis/jiy260.Peer-Reviewed Original ResearchConceptsCD4/CD8 ratioCSF HIV RNAHIV RNACD8 ratioCerebrospinal fluidHIV infectionHuman immunodeficiency virus ribonucleic acidCerebrospinal fluid (CSF) immune markersLog10 copies/mLStage I/IIHuman immunodeficiency virus (HIV) RNAChronic HIV infectionHigher CSF neopterinAcute HIV infectionPlasma HIV RNACopies/mLHuman immunodeficiency virus ribonucleic acid levelsRibonucleic acid levelsVirus ribonucleic acidAcute HIVCSF neopterinSCD14 levelsAcute infectionMedian ageImmune markers
2015
Deep sequencing of HIV-1 variants from paired plasma and cerebrospinal fluid during primary HIV infection
Gega A, Kozal MJ, Chiarella J, Lee E, Peterson J, Hecht FM, Liegler T, St John EP, Simen BB, Price RW, Spudich SS. Deep sequencing of HIV-1 variants from paired plasma and cerebrospinal fluid during primary HIV infection. Journal Of Virus Eradication 2015, 1: 264-268. PMID: 26855971, PMCID: PMC4743659, DOI: 10.1016/s2055-6640(20)30926-2.Peer-Reviewed Original ResearchPrimary HIV infectionHIV RNA levelsCopies/mLHIV infectionCerebrospinal fluidCSF samplesAge 32 yearsDrug resistance patternsHIV-1 variantsCSF HIVHIV plasmaHigh mutational loadMutational loadDays postDeep sequencingInfectionPilot studyLow-abundance variantsResistance variantsCells/Plasma samplesViral quasispeciesLimited dataMale participantsQuasispecies
2012
Central Nervous System Viral Invasion and Inflammation During Acute HIV Infection
Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, Suwanwela NC, Jagodzinski L, Michael N, Spudich S, van Griensven F, de Souza M, Kim J, Ananworanich J. Central Nervous System Viral Invasion and Inflammation During Acute HIV Infection. The Journal Of Infectious Diseases 2012, 206: 275-282. PMID: 22551810, PMCID: PMC3490695, DOI: 10.1093/infdis/jis326.Peer-Reviewed Original ResearchConceptsHIV RNA levelsAcute HIV infectionCSF HIV RNA levelsCopies/mLHIV infectionCerebrospinal fluidHIV RNARNA levelsPlasma HIV RNA levelsCentral nervous system eventsHuman immunodeficiency virus (HIV) infectionCSF HIV RNAFiebig stages IIntrathecal immune activationAcute retroviral syndromeImmunodeficiency virus infectionNervous system eventsMagnetic resonance imagingMagnetic resonance spectroscopy characterizationCSF neopterinBrain inflammationCNS inflammationCSF levelsHIV transmissionImmune activation
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
2008
Persistent Intrathecal Immune Activation in HIV-1-Infected Individuals on Antiretroviral Therapy
Yilmaz A, Price RW, Spudich S, Fuchs D, Hagberg L, Gisslén M. Persistent Intrathecal Immune Activation in HIV-1-Infected Individuals on Antiretroviral Therapy. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2008, 47: 168-173. PMID: 17971711, PMCID: PMC2628632, DOI: 10.1097/qai.0b013e31815ace97.Peer-Reviewed Original ResearchConceptsCSF neopterin levelsHIV-1-infected patientsHIV-1-infected individualsCSF neopterin concentrationsCSF viral loadIntrathecal immune activationAntiretroviral therapyHIV-1 RNACopies/mLNeopterin levelsViral loadNeopterin concentrationsImmune activationCSF HIV-1 RNA loadMost HIV-1-infected individualsPlasma HIV-1 RNA levelsCerebrospinal fluid (CSF) neopterin levelsQuantitative HIV-1 RNAHIV-1 RNA levelsHIV-1 RNA loadCell-mediated immune responsesHIV-1 RNA quantificationHIV-1 concentrationsStable antiretroviral therapySuppressive antiretroviral therapy
2007
Immune Activation of the Central Nervous System Is Still Present after >4 Years of Effective Highly Active Antiretroviral Therapy
Edén A, Price RW, Spudich S, Fuchs D, Hagberg L, Gisslén M. Immune Activation of the Central Nervous System Is Still Present after >4 Years of Effective Highly Active Antiretroviral Therapy. The Journal Of Infectious Diseases 2007, 196: 1779-1783. PMID: 18190258, DOI: 10.1086/523648.Peer-Reviewed Original ResearchConceptsHIV RNA levelsCopies/mLActive antiretroviral therapyIntrathecal immunoactivationNeopterin levelsCerebrospinal fluidIgG indexAntiretroviral therapyPlasma HIV RNA levelsMacrophage/microglia activationHuman immunodeficiency virus (HIV) RNAUpper normal reference valueIntrathecal immunoglobulin productionYears of treatmentCentral nervous systemNormal reference valuesMicroglia activationImmune activationImmunoglobulin productionEffective treatmentCSF samplesPatientsNervous systemCell countHAART
2006
Treatment Benefit on Cerebrospinal Fluid HIV‐1 Levels in the Setting of Systemic Virological Suppression and Failure
Spudich S, Lollo N, Liegler T, Deeks SG, Price RW. Treatment Benefit on Cerebrospinal Fluid HIV‐1 Levels in the Setting of Systemic Virological Suppression and Failure. The Journal Of Infectious Diseases 2006, 194: 1686-1696. PMID: 17109340, DOI: 10.1086/508750.Peer-Reviewed Original ResearchConceptsHIV-1 RNA levelsCSF HIV-1 RNA levelsPlasma HIV-1 RNA levelsRNA levelsAntiretroviral therapyCSF inflammationCopies/Successful therapyPlasma HIV-1 RNA assaysHIV-1 RNA assaysHIV-1-infected subjectsSuppressive combination antiretroviral therapyDrug resistanceHIV-1 levelsCombination antiretroviral therapyHIV-negative subjectsGenotypic resistance testingFailure of therapyHuman immunodeficiency virusCopies/mLSubset of subjectsActive neurological diseaseCross-sectional analysisVirological suppressionImmunodeficiency virus