Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation
Objective. To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART). Methods. Cross-sectional and longitudin...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2012/467154 |
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| author | Monica Airoldi Alessandra Bandera Daria Trabattoni Benedetta Tagliabue Beatrice Arosio Alessandro Soria Veronica Rainone Giuseppe Lapadula Giorgio Annoni Mario Clerici Andrea Gori |
| author_facet | Monica Airoldi Alessandra Bandera Daria Trabattoni Benedetta Tagliabue Beatrice Arosio Alessandro Soria Veronica Rainone Giuseppe Lapadula Giorgio Annoni Mario Clerici Andrea Gori |
| author_sort | Monica Airoldi |
| collection | DOAJ |
| description | Objective. To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART). Methods. Cross-sectional and longitudinal analysis of HIV RNA, proinflammatory cytokines (IL-6, IL-10, INF-γ, TNF-α, TGF-β1, and TGF-β2) and chemokines (MIP-1α, MIP-1β, and MCP-1) in plasma and cerebrospinal fluid (CSF) of HIV-infected patients with CD4 <200/μL. Results. HAND was diagnosed at baseline in 6/12 patients. Baseline CSF HIV-RNA was comparable in patients with or without HAND, whereas CSF concentration of IL-6 and MIP-1β, proinflammatory cytokines, was increased in HAND patients. CSF evaluation at 12 weeks was available in 10/12 cases. ART greatly reduced HIV-RNA in all patients. Nevertheless, IL-6 and MIP-1β remained elevated after 12 weeks of therapy in HAND patients, in whom CSF HIV RNA decay was slower than the plasmatic one as well. Conclusion. Immune activation, as indicated by inflammatory cytokines, but not higher levels of HIV-RNA is observed in advanced naïve HIV-infected patients with HAND. In HAND patients, ART introduction resulted in a less rapid clearance of CSF viremia compared to plasma and no modifications of intratechal immune activation. |
| format | Article |
| id | doaj-art-c1a8f8056d9c4aac8737d05aa727e121 |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Developmental Immunology |
| spelling | doaj-art-c1a8f8056d9c4aac8737d05aa727e1212025-02-03T01:10:49ZengWileyClinical and Developmental Immunology1740-25221740-25302012-01-01201210.1155/2012/467154467154Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune ActivationMonica Airoldi0Alessandra Bandera1Daria Trabattoni2Benedetta Tagliabue3Beatrice Arosio4Alessandro Soria5Veronica Rainone6Giuseppe Lapadula7Giorgio Annoni8Mario Clerici9Andrea Gori10Division of Infectious Diseases, Department of Internal Medicine, “San Gerardo” Hospital, University of Milan-Bicocca, 20900 Monza, ItalyDivision of Infectious Diseases, Department of Internal Medicine, “San Gerardo” Hospital, University of Milan-Bicocca, 20900 Monza, ItalyLITA VIALBA, University of Milan, 20157 Milan, ItalyDepartment of Clinical Medicine and Prevention, University of Milan-Bicocca, SCC Geriatrics, 20900 Monza, ItalyGeriatric Unit, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, 20122 Milan, ItalyDivision of Infectious Diseases, Department of Internal Medicine, “San Gerardo” Hospital, University of Milan-Bicocca, 20900 Monza, ItalyLITA VIALBA, University of Milan, 20157 Milan, ItalyDivision of Infectious Diseases, Department of Internal Medicine, “San Gerardo” Hospital, University of Milan-Bicocca, 20900 Monza, ItalyDepartment of Clinical Medicine and Prevention, University of Milan-Bicocca, SCC Geriatrics, 20900 Monza, ItalyLITA VIALBA, University of Milan, 20157 Milan, ItalyDivision of Infectious Diseases, Department of Internal Medicine, “San Gerardo” Hospital, University of Milan-Bicocca, 20900 Monza, ItalyObjective. To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART). Methods. Cross-sectional and longitudinal analysis of HIV RNA, proinflammatory cytokines (IL-6, IL-10, INF-γ, TNF-α, TGF-β1, and TGF-β2) and chemokines (MIP-1α, MIP-1β, and MCP-1) in plasma and cerebrospinal fluid (CSF) of HIV-infected patients with CD4 <200/μL. Results. HAND was diagnosed at baseline in 6/12 patients. Baseline CSF HIV-RNA was comparable in patients with or without HAND, whereas CSF concentration of IL-6 and MIP-1β, proinflammatory cytokines, was increased in HAND patients. CSF evaluation at 12 weeks was available in 10/12 cases. ART greatly reduced HIV-RNA in all patients. Nevertheless, IL-6 and MIP-1β remained elevated after 12 weeks of therapy in HAND patients, in whom CSF HIV RNA decay was slower than the plasmatic one as well. Conclusion. Immune activation, as indicated by inflammatory cytokines, but not higher levels of HIV-RNA is observed in advanced naïve HIV-infected patients with HAND. In HAND patients, ART introduction resulted in a less rapid clearance of CSF viremia compared to plasma and no modifications of intratechal immune activation.http://dx.doi.org/10.1155/2012/467154 |
| spellingShingle | Monica Airoldi Alessandra Bandera Daria Trabattoni Benedetta Tagliabue Beatrice Arosio Alessandro Soria Veronica Rainone Giuseppe Lapadula Giorgio Annoni Mario Clerici Andrea Gori Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation Clinical and Developmental Immunology |
| title | Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation |
| title_full | Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation |
| title_fullStr | Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation |
| title_full_unstemmed | Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation |
| title_short | Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation |
| title_sort | neurocognitive impairment in hiv infected naive patients with advanced disease the role of virus and intrathecal immune activation |
| url | http://dx.doi.org/10.1155/2012/467154 |
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