Abstract
In order to determine HIV-1 kinetics in cerebrospinal fluid (CSF) and plasma in patients with cryptococcal meningitis (CM), we undertook a prospective collection of paired CSF/plasma samples from antiretroviral therapy-free HIV-infected patients with CM. Samples were obtained at baseline (S1) and at the second (S2) and third (S3) weeks of antifungal therapy. HIV-1 CSF concentrations were significantly lower in both S2 and S3 with respect to S1. Plasma concentrations remained stable. HIV-1 concentrations were higher in plasma than CSF in all cases. Patients who survived the episode of CM (but not those who died) showed a decrease in CSF viral load, what suggests different viral kinetics of HIV-1 in the CSF according to the clinical course of this opportunistic disease.
Highlights
We previously reported on factors that influence cerebrospinal fluid (CSF) HIV-1 concentrations in patients with meningitis by Cryptococcus neoformans.9 The purpose of the present investigation was to study HIV-1 dynamics during the first 3 weeks of antifungal therapy and to compare concentrations of HIV-1 in the CSF and in the plasma of patients with cryptococcal meningitis
We previously reported on factors that influence CSF HIV-1 concentrations in patients with meningitis by Cryptococcus neoformans
All samples were routinely cultured on Sabouraud agar plates to enable the detection of ings performed in the Mycology Unit; MBB, design of the study, was supervisor of the proceedings performed in the Virology Unit, and cowriter and final supervisor of the manuscript; JAB, design and general supervision of the study, and was co-writer and final supervisor of the manuscript
Summary
We previously reported on factors that influence CSF HIV-1 concentrations in patients with meningitis by Cryptococcus neoformans.9 The purpose of the present investigation was to study HIV-1 dynamics during the first 3 weeks of antifungal therapy and to compare concentrations of HIV-1 in the CSF and in the plasma of patients with cryptococcal meningitis. Because of the observational nature of the study, all CSF samples were collected on the primary physician’s judgment as part of routine care for patients with cryptococcal meningitis based on local/institutional standards and international recommendations.
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