Concentrations of Human Immunodeficiency Virus Type 1 (HIV-1) RNA in Cerebrospinal Fluid after Antiretroviral Treatment Initiated during Primary HIV-1 Infection

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Abstract
In 6 patients with primary human immunodeficiency virus type 1 (HIV-1) infection, concentrations of HIV-1 RNA and β2-microglobulin were monitored in cerebrospinal fluid (CSF) and in plasma during antiretroviral therapy. Four patients had neurological symptoms. At baseline, the CSF of 5 patients had detectable levels of HIV-1 RNA (median, 3.68 log10 copies/mL; range, 10 copies/mL), and the CSF of 3 patients had elevated levels of β2-microglobulin. After 8 weeks of treatment, the median concentrations of HIV-1 RNA in CSF had decreased to 10 copies/mL (range, 10 copies/mL; P = .04) and in plasma to 3.07 log10 copies/mL (range, 2.57–3.79 log10 copies/mL; P = .03). Median concentration of β2-microglobulin in CSF had decreased to 1.2 mg/L (range, 0.9–1.7 mg/L; P = .06) and, in plasma, to 1.7 mg/L (range, 1.1–2.2 mg/L; P = .03). After 48 weeks, HIV-1 RNA concentrations in 1 patient were still 1.97 log10 copies/mL in CSF and 1.51 log10 copies/mL in plasma, although β2-microglobulin concentrations in CSF and plasma had normalized after 8 weeks.