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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Acknowledgments
The authors thank the patients and staff from the Phramongkutklao Medical Center, SEARCH. and the Hawaii Center for AIDS; AFRIMS, Bethesda, and UCSF. Supported in part by NS061696, MH072388, K23AG032872, RR026136, and NS053345.
The SEARCH 001 protocol team: Phramongkutklao Hospital: Samart Nidhinandana, Sataporn Thitivichianlert, Thippawan Chuenchitra, Suchitra Sukwit, Suwicha Chitpatima; SEARCH: Wichitra Apateerapong, Benjawan Boonchokchai, George Watt, Duanghathai Suttichom, Nitiya Chomchey; Hawaii Center for AIDS: Van Nicholas Velasco; AFRIMS: Rapee Trichavaroj.
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Shiramizu, B., Ananworanich, J., Chalermchai, T. et al. Failure to clear intra-monocyte HIV infection linked to persistent neuropsychological testing impairment after first-line combined antiretroviral therapy. J. Neurovirol. 18, 69–73 (2012). https://doi.org/10.1007/s13365-011-0068-8
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DOI: https://doi.org/10.1007/s13365-011-0068-8