부산대학교 도서관

OBJECTIVE:: HIV-1 invades the brain within days post-transmission. This study quantitated cerebrospinal fluid (CSF) white blood cell count (WBC) and investigated whether it associated with plasma and CSF HIV-1 RNA during untreated acute HIV infection (AHI). DESIGN:: Seventy participants underwent lumbar puncture during Fiebig stages I-V AHI. METHOD:: WBC and HIV-1 RNA with a lower limit of quantification (LLQ) of 80 cps/mL were measured in CSF. RESULTS:: Sixty-nine (99%) participants were male, with a median age of 26. Their blood CD4+ and CD8+ T-cell counts were 335 (IQR 247,553) and 540 (IQR 357,802) cells/ul, respectively. Forty-five (64%) were in Fiebig stages III-V whereas 25 (36%) were in Feibig stages I-II. Thirty-six (59%) experienced acute retroviral syndrome. Median plasma and CSF HIV-1 RNA were 6.10 (IQR 5.15,6.78) and 3.15 (IQR 1.90,4.11) log10cps/mL, respectively. Sixteen (23%) CSF samples had HIV-1 RNA below LLQ. Median CSF WBC was 2.5 (IQR 1,8) cells/mm. CSF pleocytosis (WBC>5) was observed in 33% and was only present in CSF samples with detectable HIV-1 RNA. The frequencies of CSF pleocytosis during Fiebig stages III-V and among CSF samples of higher viral load (>1000 cps/mL) were 42% and 45%, respectively. Pleocytosis independently associated with CSF HIV-1 RNA in multivariate analysis (adjusted coefficient: 0.79, 95%CI: [0.41,1.14], p < 0.001) and a lower plasma to CSF HIV-1 RNA ratio (p < 0.001). CONCLUSIONS:: CSF pleocytosis was present in one-third of participants with AHI. It associated with higher CSF HIV-1 RNA and a lower plasma to CSF HIV-1 RNA ratio, suggesting a potential association with HIV-1 neuroinvasion.