Www.ias2015.org Association between CSF and peripheral markers of immune- activation/inflammation and elevated intratechal HIV–RNA levels in a cohort of.

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Presentation transcript:

Association between CSF and peripheral markers of immune- activation/inflammation and elevated intratechal HIV–RNA levels in a cohort of HIV-infected antiretroviral naïve individuals Esther Merlini, PhD Clinic of Infectious Diseases Department of Health Sciences University of Milan

150 HIV+ cART naive pts Lumbar puncture and blood sampling for HIV- RNA quantification and Immune phenotypes 92/150pts neurocognitive screening tests 64/92 pts CSF/plasma inflammation marker measurements Objective: Objective: To investigate the possible associations between high CSF HIV-RNA and CSF and peripheral blood inflammatory biomarkers in a cohort of antiretroviral-naïve HIV-positive patients (pts) Study Design: Results: No differences in neurocognitive screening test (MMSE, IHDS, FAB) performance between H-CSF and L-CSF (37% vs 40%)

Univariate Logistic RegressionOR95% CIP value Plasma Log 10 HIV-RNA (each Log 10 UI/mL more) Current CD4+ T cells (each cells/mmc more) Nadir CD4+ T cells (each cells/mmc more) CD4/CD8 ratio (each unit more) CD8+CD38+ % (each unit more) CD8+CD38+CD45R0+ % (each unit more) CD4+CD127+ % (each unit more) CD8+CD45R0+ % (each unit more) CD4+CD45RA+ % (each unit more) CD8+CD45RA+ % (each unit more) Multivariate Logistic Regression AOR*95% CIP value Plasma Log 10 HIV-RNA (each Log 10 UI/mL more) CD4/CD8 ratio (each unit more) CD4+CD127+ % (each unit more) CD8+CD45RA+ % (each unit more) CD8+CD38+ % (each unit more) Factors associated to high CSF HIV RNA- Multivariate Logistic Regression Factors associated with high CSF HIV RNA- Univariate Logistic Regression *Mutually adjusted

CSF pro-inflammatory cytokine/chemokines

Conclusions In our cohort of HIV+ cART naïve patients, we failed to observe any impairment in first line neurocognitive assessment in individuals with high viral replication in the CNS compartment Pts displaying high CSF VL are characterized by lower naïve CD8+ T-cell compartment and higher peripheral and central immune-activation, suggesting an exhaustion of peripheral immune system, likely related to ongoing chronic replicative infection Further research should better assess the significance of pre- therapy high CSF viral replication on clinical and immunological reconstitution on cART

Acknowledgements University of Milan Dept of Health Sciences University of Torino Dept of Medical Sciences Francesca Iannuzzi Francesca Bai Mattia Trunfio Antonella d’Arminio Monforte Giulia Marchetti Stefano Bonora Andrea Calcagno