The aims of this study were to investigate the frequency of HIV-1 RNA level discordance between the cerebrospinal fluid (CSF) and plasma and of CSF viral escape (CVE) in patients with HIV-1 subtype C on antiretroviral therapy, and evaluate the CSF white blood cell (WBC) performance characteristics in predicting CSF discordance in HIV+ group and the frequency of cognitive impairment in individuals with CSF HIV discordance or escape. HIV-1 RNA levels were assessed in plasma and CSF samples from 68 HIV+ participants without opportunistic infection. CSF discordance was found in 7.4% and CVE in 10%, with comparable frequencies between HIV-1B and C. Twenty samples (29%) showed increased CSF WBC counts. This group had higher CSF and plasma HIV-1 RNA levels than the group with normal WBC counts (p < 0.0001 and 0.006, respectively). The odds of CSF discordance were 18 times higher for a person with CSF WBC count of > 5 cells/mm3 than the group with normal CSF WBC count. CSF WBC counts (cut-off of 15 cells/mm3) showed high-performance characteristics as a predictive biomarker of CSF discordance (AUC the ROC curve 0.98). The frequency of cognitive impairment for CSF escape or discordance was 83% and 80%. The odds of cognitive impairment in these groups were 19 and 15 times higher than those for an HIV(-) person. Viral discordance or escape in the CNS occurs at a comparable frequency for HIV-1C and HIV-1B. The CSF WBC count was effective as a predictive biomarker of CSF and plasma discordance.

中文翻译：

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脑脊液细胞增多作为 CSF 和血浆 HIV RNA 不一致和逃逸的预测因素。

本研究的目的是调查接受抗逆转录病毒治疗的 HIV-1 C 亚型患者脑脊液 (CSF) 和血浆之间 HIV-1 RNA 水平不一致的频率以及 CSF 病毒逃逸 (CVE) 的频率，并评估 CSF白细胞（WBC）在预测HIV+组中CSF不一致的表现特征以及CSF HIV不一致或逃避个体中认知障碍的频率。对 68 名没有机会性感染的 HIV+ 参与者的血浆和脑脊液样本中的 HIV-1 RNA 水平进行了评估。7.4% 的人发现 CSF 不一致，10% 的人发现 CVE 不一致，HIV-1B 和 C 之间的频率相当。20 个样本 (29%) 显示 CSF WBC 计数增加。该组的脑脊液和血浆 HIV-1 RNA 水平高于 WBC 计数正常的组（分别为 p < 0.0001 和 0.006）。脑脊液白细胞计数 > 5 个细胞/mm3 的人，脑脊液不一致的几率比脑脊液白细胞计数正常的人高 18 倍。CSF WBC 计数（截止值为 15 个细胞/mm3）显示出作为 CSF 不一致的预测生物标志物的高性能特征（AUC ROC 曲线 0.98）。脑脊液逃逸或不一致导致认知障碍的频率分别为 83% 和 80%。这些群体出现认知障碍的几率比 HIV(-) 感染者高 19 倍和 15 倍。HIV-1C 和 HIV-1B 中枢神经系统中病毒不一致或逃逸的发生频率相当。脑脊液白细胞计数作为脑脊液和血浆不一致的预测生物标志物是有效的。