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Undetectable HIV RNA and Beta-2 Microglobulin in Cerebrospinal Fluid
Do Not Indicate Inactive AIDS Dementia Complex in Patients on HAART
The objective
of the current study was to assess whether non-elevated cerebrospinal fluid (CSF)
markers could delineate inactive AIDS
dementia complex (ADC) in patients receiving HAART,
using neuropsychologic performance change as an indicator of ADC
stability.
The investigators used data from the
abacavir/ABC
(Ziagen) ADC trial (n = 78) and examined the patients'
neuropsychologic performance change with the Reliable Change Index
according to 3 cutoff groups: (1) CSF viral load (VL) <100 copies/mL,
(2) CSF [beta]-2 microglobulin ([beta]2m) <2.2 mg/L, and (3)
CSF VL and CSF [beta]2m below cutoffs.
Results
CSF marker cutoff groups did not define
neuropsychologic change. Linear regression showed that only CSF
VL was a weak predictor of neuropsychologic performance change.
These results led the researchers to
conclude, “HAART-treated ADC patients with baseline CSF markers
of viral and immunologic inactivity did not necessarily have inactive
ADC when followed over 12 weeks.
Furthermore, they noted, “More sensitive
CSF markers to judge the activity of ADC are urgently needed, whereas
the interpretation of these markers should be considered with caution
in HAART-treated ADC patients.”
07/13/05
Reference
L A Cysique and others. Undetectable Cerebrospinal Fluid HIV
RNA and [beta]-2 Microglobulin Do Not Indicate Inactive AIDS Dementia
Complex in Highly Active Antiretroviral Therapy-Treated Patients.
Journal of Acquired Immune Deficiency Syndromes 39(4): 426-429,
August 1, 2005.
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