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. 2012 Feb;18(1):69-73.
doi: 10.1007/s13365-011-0068-8. Epub 2011 Dec 30.

Failure to clear intra-monocyte HIV infection linked to persistent neuropsychological testing impairment after first-line combined antiretroviral therapy

B Shiramizu  1 , J Ananworanich, T Chalermchai, U Siangphoe, D Troelstrup, C Shikuma, V De Grutolla, P Sithinamsuwan, P Praihirunkit, S Rattanamanee, V Valcour; SEARCH 001.1 Study Group
Collaborators, Affiliations

Failure to clear intra-monocyte HIV infection linked to persistent neuropsychological testing impairment after first-line combined antiretroviral therapy

B Shiramizu et al. J Neurovirol. 2012 Feb.

Abstract

HIV-associated neurocognitive disorders (HAND) persist despite plasma HIV RNA suppression with antiretrovirals (ARV). Sequestered reservoirs in the central nervous system and circulating monocytes are theorized to contribute to persistent brain injury. We previously demonstrated that elevated intracellular HIV DNA from circulating cells was associated with HAND in ARV-treated and ARV-naive subjects. We now report that failure to suppress intra-monocyte HIV DNA 3.5 years after initiating ARV is linked to persistent HAND and subjects with dementia are least likely to suppress intra-monocyte HIV DNA at 3.5 years. These findings suggest that antiviral strategies may need to target intra-monocyte HIV DNA.

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Figures

Fig. 1
Fig. 1
HIV DNA (log10 median with inter-quartile range) in peripheral mononuclear cells (PBMC, top; monocytes, middle; and monocyte-depleted PBMC, bottom) comparing dementia cases (black circle) to non-dementia cases (white circle). Some CART-naïve individuals with dementia at baseline were unable to suppress monocyte HIV DNA after 3.5 years on CART resulting in a higher median HIV DNA copies in the dementia group
See this image and copyright information in PMC

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