Even in patients who receive long-term anti-retroviral treatment, cells containing HIV remain in the cerebrospinal fluid of half of those treated for the disease, and those individuals are more likely to experience cognitive deficits than those without cells that have HIV, a new study has found.
The study, published July 15 in the Journal of Clinical Investigation, may help answer questions about why, despite current anti-HIV therapy, some persons living with HIV still experience problems with memory, concentration, and the ability to complete complex tasks.
“In developing new methods to eradicate HIV, we need to look at the central nervous system more closely,” said Yale’s Serena Spudich, the Dr. Harry M. Zimmerman and Dr. Nicholas and Viola Spinelli Professor of Neurology, and co-lead author of the study.
With funding from the National Institute of Health’s AIDS Clinical Trials Group, researchers at Yale, the University of North Carolina, and the University of Pittsburgh examined cerebrospinal fluid from 69 individuals, all of whom had undergone long-term, anti-HIV therapy. Scientists have known that many people who receive long-term treatment continue to harbor HIV DNA in a few blood cells. When treatment is stopped, the presence of these cells can cause a recurrence of active infection. However, the persistence of cells with HIV in the central nervous system cells was not known.
Using very sensitive methods of detecting HIV, researchers revealed that almost half patients harbored viral DNA in cells found in the cerebrospinal fluid. And of those, 30% met criteria for cognitive impairment, the study found.
Researchers stressed that they did not establish that the presence of these cells caused the cognitive impairment and there could be several explanations for the findings. For instance, it is possible that the level of original infection in the central nervous system was higher in the group with cells harboring HIV, they said.
John Mellors of the University of Pittsburgh is senior author of the study. The late Kevin R. Robertson of the University of North Carolina is co-lead author.