HIV-1 escape in the central nervous system on elvitegravir-based antiretroviral therapy

Guerveno, Claire; Raymond, Stéphanie; Metsu, David; Gandia, Peggy; Izopet, Jacques; Martin‐Blondel, Guillaume; Delobel, Pierre

doi:10.1097/qad.0000000000002089

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…The median age of PLHIV diagnosed with CSF HIV escape was 43 years (range: ). This study involved 21 case reports 11,12,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30,31,33,38 and six case series. 29,[33][34][35][36][37] Sixteen (80%) of case reports were from Europe, followed by USA (three cases) and India (one case).…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

Cerebrospinal fluid viral escape in HIV patients on antiretroviral therapy: A systematic review of reported cases

Nyondo,

Njiro,

Bwire

2024

Reviews in Medical Virology

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Cerebrospinal fluid (CSF) viral escape rarely occurs when HIV is detected in the CSF, while it is undetectable in the blood plasma or detectable in CSF at levels that exceed those in the blood plasma. We conducted this review to comprehensively synthesise its clinical presentation, diagnosis, management strategies and treatment outcomes. A review registered with PROSPERO (CRD42023475311) searched evidence across PubMed/MEDLINE, Embase, Web of Science, Scopus, and Google Scholar to gather articles (case reports/series) that report on CSF viral escape in people living with HIV (PLHIV) on antiretroviral therapy (ART). The quality of studies was assessed based on the domains of selection, ascertainment, causality, and reporting. A systematic search identified 493 articles and 27 studies that include 21 case reports, and six case series were involved in the review. The studies reported 62 cases of CSF viral escape in PLHIV. The majority were men (66.67%), with a median age of 43 (range: 28–73) years. Approximately, 31 distinct symptoms were documented, mostly being cognitive dysfunction, gait abnormalities, and tremors (12.51%). Diagnosis involved blood and CSF analysis, magnetic resonance imaging, and neuropsychological assessments. Over 36 ART regimens were employed, with a focus on ART intensification; almost one‐third of the regimens contained Raltegravir (integrase strand transfer inhibitor). The outcomes showed 64.49% full recovery, 30.16% partial recovery, and 4.76% died. When neuropsychological symptoms manifest in PLHIV, monitoring for CSF viral escape is essential, regardless of plasma viral suppression. Personalised treatment strategies, particularly ART intensification, are strongly advised for optimising treatment outcomes in PLHIV diagnosed with CSF HIV escape.

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Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

Cerebrospinal fluid viral escape in HIV patients on antiretroviral therapy: A systematic review of reported cases

Nyondo,

Njiro,

Bwire

2024

Reviews in Medical Virology

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“…In addition to providing a platform for viral rebound ( Avalos et al, 2017 ; Honeycutt et al, 2017 ; Abreu et al, 2019 ) and/or escape mutations ( Guerveno et al, 2019 ; Ferretti et al, 2020 ), persistently infected myeloid populations are also the central drivers of neuroHIV ( Navia et al, 1986 ; Minagar et al, 2002 ; Crowe et al, 2003 ; Yadav and Collman, 2009 ; Williams et al, 2013 ; Joseph et al, 2015 ; Rappaport and Volsky, 2015 ; Avalos et al, 2017 ; Clayton et al, 2017 ; Mallard and Williams, 2018 ). Infected and uninfected myeloid cells respond to HIV infection by releasing inflammatory cytokines and other factors, and infected cells also release viral proteins ( Roberts et al, 2003 ; Burdo et al, 2013 ).…”

Section: Regional and Disease-specific Effects Of Dopaminementioning

confidence: 99%

Dopamine, Immunity, and Disease

et al. 2022

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The neurotransmitter dopamine is a key factor in central nervous system (CNS) function, regulating many processes including reward, movement, and cognition. Dopamine also regulates critical functions in peripheral organs, such as blood pressure, renal activity, and intestinal motility. Beyond these functions, a growing body of evidence indicates that dopamine is an important immunoregulatory factor. Most types of immune cells express dopamine receptors and other dopaminergic proteins, and many immune cells take up, produce, store, and/or release dopamine, suggesting that dopaminergic immunomodulation is important for immune function. Targeting these pathways could be a promising avenue for the treatment of inflammation and disease, but despite increasing research in this area, data on the specific effects of dopamine on many immune cells and disease processes remain inconsistent and poorly understood. Therefore, this review integrates the current knowledge of the role of dopamine in immune cell function and inflammatory signaling across systems. We also discuss the current understanding of dopaminergic regulation of immune signaling in the CNS and peripheral tissues, highlighting the role of dopaminergic immunomodulation in diseases such as Parkinson’s disease, several neuropsychiatric conditions, neurologic human immunodeficiency virus, inflammatory bowel disease, rheumatoid arthritis, and others. Careful consideration is given to the influence of experimental design on results, and we note a number of areas in need of further research. Overall, this review integrates our knowledge of dopaminergic immunology at the cellular, tissue, and disease level and prompts the development of therapeutics and strategies targeted toward ameliorating disease through dopaminergic regulation of immunity. Significance Statement Canonically, dopamine is recognized as a neurotransmitter involved in the regulation of movement, cognition, and reward. However, dopamine also acts as an immune modulator in the central nervous system and periphery. This review comprehensively assesses the current knowledge of dopaminergic immunomodulation and the role of dopamine in disease pathogenesis at the cellular and tissue level. This will provide broad access to this information across fields, identify areas in need of further investigation, and drive the development of dopaminergic therapeutic strategies.

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