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Markers of immune activation and viral load in HIV-associated sensory neuropathy.
Neurology. 2005 Mar 08; 64(5):842-8.Neur

Abstract

BACKGROUND

HIV infection is associated with a painful distal sensory polyneuropathy (DSP) that can severely limit the quality of life of affected subjects. The pathogenesis of DSP is unknown, although both HIV proteins and products of immune activation triggered by HIV infection have been implicated.

OBJECTIVE

To assess the association between baseline markers of immune activation and HIV RNA levels (viral load) and time to symptomatic DSP (SDSP).

METHODS

A cohort of 376 subjects, most receiving highly active antiretroviral therapy (HAART), were followed semiannually for up to 48 months. Blood and CSF levels of HIV viral load, monocyte chemotactic protein-1, macrophage colony-stimulating factor (M-CSF), matrix metalloproteinase-2, and tumor necrosis factor-alpha were measured in addition to CD4 lymphocyte cell count.

RESULTS

In subjects without SDSP at baseline (62.5% of the cohort), among the virologic and immunologic markers, only baseline CSF M-CSF levels were associated with time to SDSP (hazard ratio = 2.97, p = 0.05). The Kaplan-Meier estimate of the 1-year incidence of SDSP was 21%, a 15% decrease from that observed in the Dana cohort, a pre-HAART cohort enrolled with the same inclusion/exclusion criteria.

CONCLUSION

Highly active retroviral therapy (HAART) has changed the natural history of HIV-associated symptomatic distal sensory polyneuropathy (SDSP), which may explain, in contrast with studies from the pre-HAART era, the lack of association between SDSP and baseline HIV viral load and CD4 cell count.

Authors+Show Affiliations

Department of Neurology, University of Rochester, 601 Elmwood Ave., Box 673, Rochester, NY 14642, USA. Giovanni.schifitto@ctcc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15753420

Citation

Schifitto, G, et al. "Markers of Immune Activation and Viral Load in HIV-associated Sensory Neuropathy." Neurology, vol. 64, no. 5, 2005, pp. 842-8.
Schifitto G, McDermott MP, McArthur JC, et al. Markers of immune activation and viral load in HIV-associated sensory neuropathy. Neurology. 2005;64(5):842-8.
Schifitto, G., McDermott, M. P., McArthur, J. C., Marder, K., Sacktor, N., McClernon, D. R., Conant, K., Cohen, B., Epstein, L. G., & Kieburtz, K. (2005). Markers of immune activation and viral load in HIV-associated sensory neuropathy. Neurology, 64(5), 842-8.
Schifitto G, et al. Markers of Immune Activation and Viral Load in HIV-associated Sensory Neuropathy. Neurology. 2005 Mar 8;64(5):842-8. PubMed PMID: 15753420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Markers of immune activation and viral load in HIV-associated sensory neuropathy. AU - Schifitto,G, AU - McDermott,M P, AU - McArthur,J C, AU - Marder,K, AU - Sacktor,N, AU - McClernon,D R, AU - Conant,K, AU - Cohen,B, AU - Epstein,L G, AU - Kieburtz,K, AU - ,, PY - 2005/3/9/pubmed PY - 2006/2/10/medline PY - 2005/3/9/entrez SP - 842 EP - 8 JF - Neurology JO - Neurology VL - 64 IS - 5 N2 - BACKGROUND: HIV infection is associated with a painful distal sensory polyneuropathy (DSP) that can severely limit the quality of life of affected subjects. The pathogenesis of DSP is unknown, although both HIV proteins and products of immune activation triggered by HIV infection have been implicated. OBJECTIVE: To assess the association between baseline markers of immune activation and HIV RNA levels (viral load) and time to symptomatic DSP (SDSP). METHODS: A cohort of 376 subjects, most receiving highly active antiretroviral therapy (HAART), were followed semiannually for up to 48 months. Blood and CSF levels of HIV viral load, monocyte chemotactic protein-1, macrophage colony-stimulating factor (M-CSF), matrix metalloproteinase-2, and tumor necrosis factor-alpha were measured in addition to CD4 lymphocyte cell count. RESULTS: In subjects without SDSP at baseline (62.5% of the cohort), among the virologic and immunologic markers, only baseline CSF M-CSF levels were associated with time to SDSP (hazard ratio = 2.97, p = 0.05). The Kaplan-Meier estimate of the 1-year incidence of SDSP was 21%, a 15% decrease from that observed in the Dana cohort, a pre-HAART cohort enrolled with the same inclusion/exclusion criteria. CONCLUSION: Highly active retroviral therapy (HAART) has changed the natural history of HIV-associated symptomatic distal sensory polyneuropathy (SDSP), which may explain, in contrast with studies from the pre-HAART era, the lack of association between SDSP and baseline HIV viral load and CD4 cell count. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15753420/Markers_of_immune_activation_and_viral_load_in_HIV_associated_sensory_neuropathy_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15753420 DB - PRIME DP - Unbound Medicine ER -