2025
Longitudinal CNS and systemic T-lymphocyte and monocyte activation before and after antiretroviral therapy beginning in primary HIV infection
Chan P, Li X, Li F, Emu B, Price R, Spudich S. Longitudinal CNS and systemic T-lymphocyte and monocyte activation before and after antiretroviral therapy beginning in primary HIV infection. Frontiers In Immunology 2025, 16: 1531828. PMID: 40070827, PMCID: PMC11893981, DOI: 10.3389/fimmu.2025.1531828.Peer-Reviewed Original ResearchConceptsCerebrospinal fluid HIV RNAPrimary HIV infectionT cell activationCD8+ T cell activationAntiretroviral therapyHIV RNACD4+HIV infectionCerebrospinal fluidT cellsMonocyte activationNeuronal injuryCD4+ T cell activationCD8<sup>+</sup> T cellsCD8+ T cellsFrequencies of activated CD4+ART-naive peopleChronic HIV infectionTrafficking of immune cellsAntiretroviral therapy initiationChemokine receptor expressionMultiparameter flow cytometryImmune cell activationSurface marker expressionCentral nervous systemNeuropsychiatric and laboratory outcomes of hepatitis C treatment in an early-treated HIV cohort in Thailand
Ocampo F, Sacdalan C, Pinyakorn S, Paudel M, Wansom T, Poltubtim N, Sriplienchan S, Phanuphak N, Paul R, Hsu D, Colby D, Trautmann L, Spudich S, Chan P. Neuropsychiatric and laboratory outcomes of hepatitis C treatment in an early-treated HIV cohort in Thailand. AIDS Research And Therapy 2025, 22: 20. PMID: 39972347, PMCID: PMC11841302, DOI: 10.1186/s12981-025-00707-x.Peer-Reviewed Original ResearchConceptsWeeks of antiretroviral therapyAcute HIV infectionT-cell countsT cell ratioAntiretroviral therapyPatient Health Questionnaire-9HCV seroconversionDAA treatmentCD4 + and CD8 + T cell countsCD4+ /CD8+ T-cell ratioCD8+ T cell countsDirect-acting antiviral (DAA) therapyAlanine transaminaseCD4+ /CD8+ ratioAspartate transferaseIntravenous drug useEarly HCV infectionSexually transmitted infectionsFollow-up visitPatient Health Questionnaire-9 scoresBackgroundHepatitis C virusHepatitis C treatmentHIV RNAVirological responseDAA therapy
2024
Central Nervous System Effects of Early HIV Infection and Consequences of Antiretroviral Therapy Initiation during Acute HIV
Chan P, Spudich S. Central Nervous System Effects of Early HIV Infection and Consequences of Antiretroviral Therapy Initiation during Acute HIV. Viruses 2024, 16: 1082. PMID: 39066244, PMCID: PMC11281648, DOI: 10.3390/v16071082.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsEarly HIV infectionCentral nervous systemHIV infectionEffects of early HIV infectionIncrease awareness of HIV infectionCentral nervous system opportunistic infectionsImmediate initiation of antiretroviral therapyInitiation of antiretroviral therapyAwareness of HIV infectionCentral nervous system complicationsCentral nervous system involvementAntiretroviral therapy initiationCentral nervous system effectsLong-term neuroprotectionHIV-associated dementiaOvert clinical manifestationsYears of infectionMulti-organ diseaseNucleic acid testingAcute HIVHIV neuroinvasionHIV RNAAntiretroviral therapyOpportunistic infectionsTherapy initiationFramingham risk score based vascular outcomes in acute versus chronic HIV cohorts after 6 years of ART
Holroyd K, Han W, Apornpong T, Trautmann L, Gatechompol S, Hiransuthikul A, Ubolyam S, Sacdalan C, Sriplienchan S, Kanaprach R, Kerr S, Avihingsanon A, Spudich S, Chan P. Framingham risk score based vascular outcomes in acute versus chronic HIV cohorts after 6 years of ART. HIV Medicine 2024, 25: 725-736. PMID: 38383057, DOI: 10.1111/hiv.13621.Peer-Reviewed Original ResearchConceptsFramingham risk scoreYears of antiretroviral therapyAcute HIVHigher CD4 countsAntiretroviral therapyChronic HIVCD4 countFollow-upAtherosclerotic cardiovascular diseaseVascular outcomesAssociated with higher body mass indexCardiovascular diseaseRisk scoreHigher body mass indexRisk factorsPrevalence of syphilisVascular agingCD8 T-cell countsMetabolic risk factorsCohort of participantsBody mass indexMultivariate linear regression analysisCardiovascular risk factorsEffect of ART initiationStarted antiretroviral therapy
2023
Cerebrospinal fluid pleocytosis is associated with HIV-1 neuroinvasion during acute infection
Chan P, Moreland S, Sacdalan C, Kroon E, Colby D, Sriplienchan S, Pinyakorn S, Phanuphak N, Jagodzinski L, Valcour V, Vasan S, Paul R, Trautmann L, Spudich S, Team O. Cerebrospinal fluid pleocytosis is associated with HIV-1 neuroinvasion during acute infection. AIDS 2023, 38: 373-378. PMID: 37916464, PMCID: PMC10842649, DOI: 10.1097/qad.0000000000003777.Peer-Reviewed Original ResearchCSF HIV-1 RNAWhite blood cell countHIV-1 RNAAcute HIV infectionCp/mLCSF pleocytosisCSF samplesLower plasmaCerebrospinal fluid white blood cell countMedian CSF white blood cell countStage ICSF white blood cell countDetectable HIV-1 RNAFiebig stage IIIFiebig stages ICerebrospinal fluid pleocytosisT-cell countsAcute retroviral syndromeHigh viral loadBlood cell countCells/Blood CD4Acute infectionHIV infectionMedian ageBrain volumetrics differ by Fiebig stage in acute HIV infection
Bolzenius J, Sacdalan C, Ndhlovu L, Sailasuta N, Trautmann L, Tipsuk S, Crowell T, Suttichom D, Colby D, Phanuphak N, Chan P, Premeaux T, Kroon E, Vasan S, Hsu D, Valcour V, Ananworanich J, Robb M, Ake J, Pohl K, Sriplienchan S, Spudich S, Paul R. Brain volumetrics differ by Fiebig stage in acute HIV infection. AIDS 2023, 37: 861-869. PMID: 36723491, PMCID: PMC10079583, DOI: 10.1097/qad.0000000000003496.Peer-Reviewed Original ResearchConceptsAcute HIV infectionNucleus accumbensFiebig stagesAcute infectionHIV infectionCaudate nucleusBrain volumeLower regional brain volumesAntiretroviral therapy initiationMarkers of neuroinflammationBrain volume alterationsCross-sectional studyRegional brain volumesT1-weighted scansTherapy initiationChronic infectionBrain volumetricsBrain disruptionThai malesViral factorsPutamenVolume alterationsAccumbensInfectionStimulant use
2022
Individual Differences in CD4/CD8 T-Cell Ratio Trajectories and Associated Risk Profiles Modeled From Acute HIV Infection
Paul R, Cho K, Bolzenius J, Sacdalan C, Ndhlovu LC, Trautmann L, Krebs S, Tipsuk S, Crowell TA, Suttichom D, Colby DJ, Premeaux TA, Phanuphak N, Chan P, Kroon E, Vasan S, Hsu D, Carrico A, Valcour V, Ananworanich J, Robb ML, Ake JA, Sriplienchan S, Spudich S, Team F. Individual Differences in CD4/CD8 T-Cell Ratio Trajectories and Associated Risk Profiles Modeled From Acute HIV Infection. Psychosomatic Medicine 2022, 84: 976-983. PMID: 36162059, PMCID: PMC9553252, DOI: 10.1097/psy.0000000000001129.Peer-Reviewed Original ResearchConceptsAcute HIV infectionCD4/CD8 T-cell ratioCD8 T-cell ratioAntiretroviral therapyT-cell countsT-cell recoveryT cell ratioHigh viral loadViral loadHigh CD8Slower CD4HIV infectionLower white blood cell countWeeks of ARTRisk profileWhite blood cell countT-cell trajectoriesMedian viral loadStandard antiretroviral therapyBlood cell countLower eosinophil countsWorse mental healthAHI participantsART onsetFiebig IImmunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection
Chan P, Yoon B, Colby D, Kroon E, Sacdalan C, Sriplienchan S, Pinyakorn S, Ananworanich J, Valcour V, Vasan S, Hsu D, Phanuphak N, Paul R, Spudich S. Immunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection. Clinical Infectious Diseases 2022, 76: e718-e726. PMID: 35687498, PMCID: PMC9907536, DOI: 10.1093/cid/ciac466.Peer-Reviewed Original ResearchConceptsAcute HIV-1 infectionT-cell countsDTG-based antiretroviral therapyAntiretroviral therapyDTG groupEFV groupWeek 96Week 24CD4/CD8 ratioNucleoside reverse transcriptase inhibitorHuman immunodeficiency virus type 1Immunodeficiency virus type 1Fiebig stages IPlasma viral suppressionAcute HIV infectionTreatment-naive individualsHIV-1 infectionPatient Health QuestionnaireReverse transcriptase inhibitorVirus type 1Greater incrementART regimensCD8 ratioViral suppressionHIV infectionHIV Compartmentalization in the CNS and Its Impact in Treatment Outcomes and Cure Strategies
Chan P, Spudich S. HIV Compartmentalization in the CNS and Its Impact in Treatment Outcomes and Cure Strategies. Current HIV/AIDS Reports 2022, 19: 207-216. PMID: 35536438, PMCID: PMC10590959, DOI: 10.1007/s11904-022-00605-1.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHIV-1 escapeAntiretroviral therapyCentral nervous system reservoirHIV-1 infection resultsStable antiretroviral therapyCerebrospinal fluid findingsWorse neurocognitive performanceTreatment interruption studiesHIV compartmentalizationCNS reservoirsCure strategiesChronic infectionTreatment outcomesCells persistRecent FindingsComparedInfection resultsReviewThis reviewViral variantsViral replicationSummaryFuture studiesNeurocognitive performanceInterruption studiesSystemic reservoirInfected cellsLongitudinal benefits
2021
Cerebrospinal fluid CD4+ T cell infection in humans and macaques during acute HIV-1 and SHIV infection
Sharma V, Creegan M, Tokarev A, Hsu D, Slike BM, Sacdalan C, Chan P, Spudich S, Ananworanich J, Eller MA, Krebs SJ, Vasan S, Bolton DL. Cerebrospinal fluid CD4+ T cell infection in humans and macaques during acute HIV-1 and SHIV infection. PLOS Pathogens 2021, 17: e1010105. PMID: 34874976, PMCID: PMC8683024, DOI: 10.1371/journal.ppat.1010105.Peer-Reviewed Original ResearchConceptsT-cell infectionCentral nervous systemAcute HIV-1HIV-1 replicationCerebrospinal fluidT cellsHIV-1Peripheral bloodViral reservoirCell infectionBroad immune activationCerebrospinal fluid CD4CNS viral reservoirCSF T cellsHIV-1 cureActive viral transcriptionLong-term inflammationViral RNACSF CD4Early neuroinflammationAntiretroviral therapyHuman cerebrospinal fluidAcute infectionImmune activationCNS compartmentInvestigating vascular diseases in people living with HIV by nuclear imaging
Chan P, Spudich S. Investigating vascular diseases in people living with HIV by nuclear imaging. Journal Of Nuclear Cardiology 2021, 29: 1576-1582. PMID: 33884573, DOI: 10.1007/s12350-021-02613-x.Commentaries, Editorials and LettersClinical and laboratory impact of concomitant syphilis infection during acute HIV
Chan P, Colby D, Kroon E, Sacdalan C, Pinyakorn S, Paul R, Robb M, Valcour V, Ananworanich J, Marra C, Spudich S. Clinical and laboratory impact of concomitant syphilis infection during acute HIV. HIV Medicine 2021, 22: 502-511. PMID: 33728759, DOI: 10.1111/hiv.13079.Peer-Reviewed Original ResearchConceptsAcute HIV-1T lymphocyte levelsVenereal Disease Research LaboratoryUntreated syphilisHistory of syphilisHIV-1Higher plasma HIV-1 RNACD4 T-lymphocyte levelsPlasma HIV-1 RNAHIV-1 RNA levelsCognitive performanceCD4 T lymphocytesHIV-1 infectionHIV-1 RNAImpaired cognitive performanceAcute HIVAHI participantsFiebig stagesIncident syphilisPrior syphilisSerum TreponemaSyphilis infectionChronic infectionDisease measuresSyphilis statusCognitive trajectories after treatment in acute HIV infection
Chan P, Kerr SJ, Kroon E, Colby D, Sacdalan C, Hellmuth J, Reiss P, Vasan S, Ananworanich J, Valcour V, Spudich S, Paul R. Cognitive trajectories after treatment in acute HIV infection. AIDS 2021, 35: 883-888. PMID: 33534200, DOI: 10.1097/qad.0000000000002831.Peer-Reviewed Original ResearchConceptsAcute HIV-1 infectionAntiretroviral therapyWeek 288Week 96Cognitive performanceAcute HIV infectionSuppressive antiretroviral therapyHIV-1 infectionTrajectory subgroupsWorse depressive symptomsWorse baseline cognitive performanceImpaired cognitive performanceFine motor speedAHI diagnosisViral suppressionHIV infectionWeek 12Baseline cognitive performanceLower baseline performanceHIV-1Depressive symptomsCognitive symptomsPosthoc analysisPsychomotor speedCognitive outcomes
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 treatmentCentral Nervous System Safety During Brief Analytic Treatment Interruption of Antiretroviral Therapy Within 4 Human Immunodeficiency Virus Remission Trials: An Observational Study in Acutely Treated People Living With Human Immunodeficiency Virus
Hellmuth J, Muccini C, Colby DJ, Kroon E, de Souza M, Crowell TA, Chan P, Sacdalan C, Intasan J, Benjapornpong K, Tipsuk S, Puttamaswin S, Chomchey N, Valcour V, Sarnecki M, Tomaka F, Krebs SJ, Slike BM, Jagodzinski LL, Dumrongpisutikul N, Sailasuta N, Samboju V, Michael NL, Robb ML, Vasan S, Ananworanich J, Phanuphak P, Phanuphak N, Paul R, Spudich S. Central Nervous System Safety During Brief Analytic Treatment Interruption of Antiretroviral Therapy Within 4 Human Immunodeficiency Virus Remission Trials: An Observational Study in Acutely Treated People Living With Human Immunodeficiency Virus. Clinical Infectious Diseases 2020, 73: e1885-e1892. PMID: 32916708, PMCID: PMC8492357, DOI: 10.1093/cid/ciaa1344.Peer-Reviewed Original ResearchConceptsAnalytic treatment interruptionHuman immunodeficiency virusAntiretroviral therapyCentral nervous systemRemission trialsDiffusion tensor imagingTreatment interruptionMedian timeImmunodeficiency virusCentral nervous system safetyCSF HIV-1 RNAAdverse CNS effectsAcute HIV infectionImmune activation markersPlasma viral loadHIV-1 RNAMedian participant ageCerebrospinal fluid samplingCognitive performanceHIV remission trialsBrain diffusion tensor imagingMagnetic resonance spectroscopyART resumptionCNS safetyMild worseningRegional brain volumetric changes despite 2 years of treatment initiated during acute HIV infection.
Kallianpur KJ, Jahanshad N, Sailasuta N, Benjapornpong K, Chan P, Pothisri M, Dumrongpisutikul N, Laws E, Ndhlovu LC, Clifford KM, Paul R, Jagodzinski L, Krebs S, Ananworanich J, Spudich S, Valcour V. Regional brain volumetric changes despite 2 years of treatment initiated during acute HIV infection. AIDS 2020, 34: 415-426. PMID: 31725432, PMCID: PMC6994348, DOI: 10.1097/qad.0000000000002436.Peer-Reviewed Original ResearchConceptsCombination antiretroviral therapyRegional brain volumesBrain volumeSuppressive combination antiretroviral therapyBrain magnetic resonance imagingBrain volumetric changesAcute HIV infectionLongitudinal pipelineProspective cohort studyBrain metabolite levelsCerebrospinal fluid biomarkersVolumetric decreaseYears of treatmentMagnetic resonance imagingFreeSurfer longitudinal pipelineVoxel-wise analysisHigh baseline frequencyVolumes of putamenCART initiationHIV-1infectionProgressive HIVSimilar HIVAntiretroviral therapyCohort studyHIV exposureResting-state neural signatures of depressive symptoms in acute HIV
Philippi CL, Reyna L, Nedderman L, Chan P, Samboju V, Chang K, Phanuphak N, Ratnaratorn N, Hellmuth J, Benjapornpong K, Dumrongpisutikul N, Pothisri M, Robb ML, Ananworanich J, Spudich S, Valcour V, Paul R. Resting-state neural signatures of depressive symptoms in acute HIV. Journal Of NeuroVirology 2020, 26: 226-240. PMID: 31989446, PMCID: PMC7261250, DOI: 10.1007/s13365-020-00826-3.Peer-Reviewed Original ResearchConceptsResting-state functional connectivityAcute HIV infectionAnterior cingulate cortexDecreased resting-state functional connectivityDepressive symptomsAltered resting-state functional connectivityCombination antiretroviral therapyPersistent depressive symptomsUninfected control groupAmygdala seed regionPosterior cingulate/precuneusSymptoms of depressionVoxelwise regression analysesEmotion-related brain regionsAcute HIVChronic HIVThai HIVAntiretroviral therapyHIV RNASeed regionHIV infectionBlood biomarkersAHI groupLateral parietal regionsUninfected controlsNeuropsychiatric outcomes before and after switching to dolutegravir-based therapy in an acute HIV cohort
Chan P, Goh O, Kroon E, Colby D, Sacdalan C, Pinyakorn S, Prueksakaew P, Reiss P, Ananworanich J, Valcour V, Spudich S, Paul R. Neuropsychiatric outcomes before and after switching to dolutegravir-based therapy in an acute HIV cohort. AIDS Research And Therapy 2020, 17: 1. PMID: 31907064, PMCID: PMC6945418, DOI: 10.1186/s12981-019-0257-8.Peer-Reviewed Original ResearchConceptsPatient Health Questionnaire-9Acute HIV infectionWeeks of ARTAntiretroviral therapyPHQ-9 scoresDTG-based antiretroviral therapyLower PHQ-9 scoresDolutegravir-based therapyDTG-based regimenNeuropsychiatric adverse eventsPlasma viral suppressionFirst-line treatmentPre-existing depressionLeast moderate depressionModerate-severe depressionModerate depression symptomsPercentage of participantsDTG useViral suppressionHIV cohortMedian durationAdverse eventsHIV infectionHighest quartileMultivariable analysis
2019
Neurosyphilis During Acute HIV Infection: A CNS Immunologic and Virologic Characterization.
Chan P, Dumrongpisutikul N, Subra C, Colby DJ, Kroon E, Fletcher J, Sacdalan C, Phanuphak N, Valcour V, Ananworanich J, Trautmann L, Spudich S. Neurosyphilis During Acute HIV Infection: A CNS Immunologic and Virologic Characterization. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2019, 82: e34-e37. PMID: 31180994, PMCID: PMC10126948, DOI: 10.1097/qai.0000000000002114.Peer-Reviewed Case Reports and Technical NotesDeep Sequencing Reveals Central Nervous System Compartmentalization in Multiple Transmitted/Founder Virus Acute HIV-1 Infection
Tovanabutra S, Sirijatuphat R, Pham PT, Bonar L, Harbolick EA, Bose M, Song H, Chang D, Oropeza C, O’Sullivan A, Balinang J, Kroon E, Colby DJ, Sacdalan C, Hellmuth J, Chan P, Prueksakaew P, Pinyakorn S, Jagodzinski LL, Sutthichom D, Pattamaswin S, de Souza M, Gramzinski RA, Kim JH, Michael NL, Robb ML, Phanuphak N, Ananworanich J, Valcour V, Kijak GH, Sanders-Buell E, Spudich S, Core T, Team T. Deep Sequencing Reveals Central Nervous System Compartmentalization in Multiple Transmitted/Founder Virus Acute HIV-1 Infection. Cells 2019, 8: 902. PMID: 31443253, PMCID: PMC6721674, DOI: 10.3390/cells8080902.Peer-Reviewed Original ResearchConceptsAcute HIV-1 infectionCentral nervous systemHIV-1 infectionCerebrospinal fluidCNS compartmentalizationHIV-1HIV-1 compartmentalizationHIV-1 exposureHIV-1 neuropathogenesisHIV-1 reservoirSingle-genome sequencingHIV reservoirFounder virusesRemission strategiesNeurological impairmentNervous systemF infectionsViral replicationInfectionPotential long-term implicationsNext-generation sequencingEnvelope geneTissue compartmentsF variantLong-term implications
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