Scientists discover two HIV variants in cerebrospinal fluid of HAD patients

August 30, 2017

"Those viruses are known to exist in autopsy brain studies. It has been known for ten years that a subset of HIV-infected patients have slow decay of the virus in the CSF, and it's also been known for a long time that you can find macrophage-tropic virus in the brain," Swanstrom said. "But no one has ever brought the two together in a way that makes sense and could give you a tool to evaluate what's going on the brain by looking at cerebrospinal fluid."

The study also found HIV-infected macrophages present in a CSF sample two years before the patient was diagnosed with dementia. Swanstrom said this tells us there's information in the CSF that potentially could predict disease progression. "Is it bad to have these viruses around even if you don't get a diagnosis of dementia? And are they potentially causing cognitive damage that can be reversed with HAART?"

To explore these and other questions, Swanstrom and Price of UCSF again will collaborate under a 5-year, $3 million grant from the National Institute of Mental Health to expand the research in HIV patients who don't have dementia and are starting therapy. The new study will look for biomarkers in the CSF in the form of HIV variants or other immune protein information that may predict improvement, stability or decrease in cognitive capacity during therapy.

In the new project, Swanstrom's UNC team will include Joseph J. Eron, MD, professor of medicine and Director of the UNC Center for AIDS Research Clinical Core, Kevin Robertson, PhD, clinical psychologist in the department of neurology, and Angela Kashuba, PharmD, associate professor, Eshelman School of Pharmacy and director, UNC Center for AIDS Research Clinical Pharmacology and Analytical Chemistry Core.

People infected with HIV sometimes delay going on HAART, Swanstrom said. "Our research will help further understand what's going on in the central nervous system of patients who are still alive and in tissue that's accessible in the clinical setting, i.e. CSF. If these individuals knew there was an AIDS virus replicating independently in their CNS, it might affect their decision when to start treatment with HAART."

Source: University of North Carolina at Chapel Hill School of Medicine