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 discordance
2014
Progressive increase in central nervous system immune activation in untreated primary HIV-1 infection
Suh J, Sinclair E, Peterson J, Lee E, Kyriakides TC, Li FY, Hagberg L, Fuchs D, Price RW, Gisslen M, Spudich S. Progressive increase in central nervous system immune activation in untreated primary HIV-1 infection. Journal Of Neuroinflammation 2014, 11: 199. PMID: 25465205, PMCID: PMC4263211, DOI: 10.1186/s12974-014-0199-y.Peer-Reviewed Original ResearchConceptsPrimary HIV-1 infectionHIV-1 infectionCSF neopterinCerebrospinal fluidT cellsHIV infectionCentral nervous system immune activationUntreated primary HIV-1 infectionBaseline levelsEarly HIV-1 infectionCSF neopterin concentrationsNervous system inflammationMixed effects modelsCluster of differentiationMajority of subjectsCNS inflammationSystem inflammationAverage followNeopterin concentrationsHIV transmissionImmune activationLumbar punctureResultsA totalIntrathecal inflammationNatural coursePeripheral Neuropathy in Primary HIV Infection Associates With Systemic and Central Nervous System Immune Activation
Wang SX, Ho EL, Grill M, Lee E, Peterson J, Robertson K, Fuchs D, Sinclair E, Price RW, Spudich S. Peripheral Neuropathy in Primary HIV Infection Associates With Systemic and Central Nervous System Immune Activation. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 66: 303-310. PMID: 24732871, PMCID: PMC4147038, DOI: 10.1097/qai.0000000000000167.Peer-Reviewed Original ResearchConceptsPrimary HIV infectionPeripheral neuropathyCerebrospinal fluidHIV infectionHIV transmissionPN subjectsCentral nervous system immune activationCSF white blood cell countPlasma HIV RNA levelsSigns of PNWhite blood cell countChronic HIV infectionHIV RNA levelsCD8 T lymphocytesDetailed neurologic examinationSymptomatic peripheral neuropathyBlood cell countChemoattractant protein-1Blood CD4Blood neopterinCD8 countsCSF neopterinBilateral findingsFrequent complicationAnalysis of blood
2013
Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy
Yilmaz A, Yiannoutsos CT, Fuchs D, Price RW, Crozier K, Hagberg L, Spudich S, Gisslén M. Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy. Journal Of Neuroinflammation 2013, 10: 828. PMID: 23664008, PMCID: PMC3657550, DOI: 10.1186/1742-2094-10-62.Peer-Reviewed Original ResearchConceptsCSF neopterin levelsAntiretroviral therapyNeopterin levelsCerebrospinal fluidCSF neopterinHAD patientsMacrophage activationART-mediated viral suppressionCommencement of ARTHigher pre-ART levelsCSF neopterin concentrationsPre-ART levelsProlonged antiretroviral therapySuppressive antiretroviral therapySet-point levelsBlood neopterinHAD subjectsART initiationAsymptomatic HIVTreatment-naïveViral suppressionNeopterin concentrationsImmune activationMost HIVHIV
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
2011
Raltegravir Treatment Intensification Does Not Alter Cerebrospinal Fluid HIV-1 Infection or Immunoactivation in Subjects on Suppressive Therapy
Dahl V, Lee E, Peterson J, Spudich SS, Leppla I, Sinclair E, Fuchs D, Palmer S, Price RW. Raltegravir Treatment Intensification Does Not Alter Cerebrospinal Fluid HIV-1 Infection or Immunoactivation in Subjects on Suppressive Therapy. The Journal Of Infectious Diseases 2011, 204: 1936-1945. PMID: 22021620, PMCID: PMC3209817, DOI: 10.1093/infdis/jir667.Peer-Reviewed Original ResearchConceptsHIV-1 RNA levelsHIV-1 RNAImmune activationRaltegravir intensificationRNA levelsPlasma human immunodeficiency virus type 1 (HIV-1) RNACSF HIV-1 RNA levelsMedian HIV-1 RNA levelT-cell surface antigen expressionHuman immunodeficiency virus type 1 (HIV-1) RNAOpen-label pilot studySingle-copy assayHIV RNA levelsCerebrospinal fluid infectionHIV-1 infectionCentral nervous systemBaseline viral suppressionSurface antigen expressionT cell activationCSF neopterinIntrathecal immunoactivationSuppressive therapyAntiretroviral therapyTreatment intensificationViral suppressionCentral Nervous System Immune Activation Characterizes Primary Human Immunodeficiency Virus 1 Infection Even in Participants With Minimal Cerebrospinal Fluid Viral Burden
Spudich S, Gisslen M, Hagberg L, Lee E, Liegler T, Brew B, Fuchs D, Tambussi G, Cinque P, Hecht FM, Price RW. Central Nervous System Immune Activation Characterizes Primary Human Immunodeficiency Virus 1 Infection Even in Participants With Minimal Cerebrospinal Fluid Viral Burden. The Journal Of Infectious Diseases 2011, 204: 753-760. PMID: 21844301, PMCID: PMC3156103, DOI: 10.1093/infdis/jir387.Peer-Reviewed Original ResearchConceptsWhite blood cell countCSF HIV RNAPrimary HIV infectionHIV RNACerebrospinal fluidPHI participantsImmune activationAlbumin ratioPrimary human immunodeficiency virus-1 infectionCentral nervous system immune activationCSF white blood cell countHuman immunodeficiency virus-1 (HIV-1) infectionHuman immunodeficiency virus (HIV) infectionHigher albumin ratioHIV-seronegative controlsImmunodeficiency virus infectionHIV-seronegative participantsCells/μLLow cerebrospinal fluidBlood cell countVirus-1 infectionCross-sectional studyMagnitude of infectionCXCL10 concentrationsPHI patients
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
Failure of atorvastatin to modulate CSF HIV-1 infection
Probasco JC, Spudich SS, Critchfield J, Lee E, Lollo N, Deeks SG, Price RW. Failure of atorvastatin to modulate CSF HIV-1 infection. Neurology 2008, 71: 521-524. PMID: 18695163, PMCID: PMC2676982, DOI: 10.1212/01.wnl.0000325006.84658.e7.Peer-Reviewed Original ResearchConceptsHIV-1 infectionHIV-1 RNA levelsT-cell countsCell countIntrathecal immunoactivationNeopterin concentrationsBlood lipidsBlood HIV-1 RNA levelCSF HIV-1 RNA levelsCSF white blood cell countCNS HIV-1 infectionSystemic HIV-1 infectionSingle-arm pilot studyWhite blood cell countPilot studyAntiretroviral-naïve subjectsCells/mulRNA levelsUntreated systemic infectionT-lymphocyte countsSmall uncontrolled studiesEffect of atorvastatinHMG-CoA reductase inhibitorsWeeks of treatmentHIV-1 RNAAntiretroviral Treatment Effect on Immune Activation Reduces Cerebrospinal Fluid HIV-1 Infection
Sinclair E, Ronquillo R, Lollo N, Deeks SG, Hunt P, Yiannoutsos CT, Spudich S, Price RW. Antiretroviral Treatment Effect on Immune Activation Reduces Cerebrospinal Fluid HIV-1 Infection. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2008, 47: 544-552. PMID: 18362693, PMCID: PMC3480328, DOI: 10.1097/qai.0b013e318162754f.Peer-Reviewed Original ResearchConceptsPlasma HIV-1 RNACD8 T cell activationHIV-1 RNACSF HIV-1 RNA levelsHIV-1 RNA levelsT cell activationWhite blood cellsHIV-1 concentrationsAntiretroviral therapyHIV-1 infectionCerebrospinal fluidCD8 activationCSF neopterinViremic groupImmune activationCopies/HIV-1CD38/HLA-DR expressionCSF HIV-1 RNA concentrationsHIV-1-infected subjectsSystemic HIV-1 infectionHIV-1 RNA concentrationsHuman leukocyte antigen-DRCSF white blood cellsCoexpression of CD38Persistent 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