Associated factors for the detection of CSF HIV-1 RNA in patients with advanced HIV infection worked up for neurological diseases in Belo Horizonte, Brazil.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. A10370)
Christo PP, Livramento JA, Aleixo AV, Greco DB Eduardo de Menezes Hospital, Belo Horizonte, Brazil
Introduction: reduction of morbidity and mortality has been achieved with the introduction of HAART and still these patients may represent a vulnerable group to neurological diseases. There are evidences that HIV replication in the CNS may be only partially suppressed and CNS HIV replication can occur relatively independently of the systemic infection. Patients with neurological diseases directly caused by HIV or by opportunistic agents can have intrathecal replication of HIV thus prompt diagnosis and treatment of may be of prognostic importance. OBJECTIVE: to evaluate associated factors in the detection of CSF HIV-1 RNA in AIDS patients with advanced HIV infection worked up for neurological diseases in Infectious Diseases Reference Hospital in Brazil. Methodology: we evaluated 90 patients divided in two groups: CSF HIV detected (50) and undetected (40). These variables were analyzed: gender, age, time of HIV diagnosis, clinical evolution, CD4 count, presence of cells and proteins in CSF, HAART use, plasma viral load and neurological disease.
RESULTS: in univariate analysis there was no difference between patients with detected or undetected viral load in relation to sex, age, time of AIDS disease, cells and protein in the CSF. The chance of death was 2.9 times higher in patients with a CSF viral load >80 copies/ml when compared to<80. Chance of CSF viral load >80 was 14 times higher in patients who were not on HAART as opposed to those on HAART. In the multivariate analysis the presence of neurological disease, low CD4 and high plasma viral load remained associated with the detection of HIV RNA in the CSF.
CONCLUSION: low CD4 count, high levels of plasma viral load and presence of neurological diseases were associated with the probability of detectable CSF HIV RNA. Probability of death was more frequent in patients with a detectable CSF HIV-1 RNA.
Keywords: AEGIS, HIV Infections, Viral Load, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Acquired Immunodeficiency Syndrome, RNA, Viral, HIV Seropositivity, Virus Replication, Granulocyte-Macrophage Colony-Stimulating Factor, RNA, Nervous System Diseases, Central Nervous System Viral Diseases, Granulocyte Macrophage Colony-Stimulating Factors,, Recombinant, Central Nervous System Infections, Brazil, Humans, virology
