HIV in the CSF: Where Does It Come From?

In some HIV-infected patients on antiretroviral therapy (ART), virus can be detected in cerebrospinal fluid (CSF). Whether such virus is produced within the central nervous system (CNS) or originates in the periphery and invades the CNS — and whether the virus in the CSF is replicating and evolving — is unknown. To address these questions, investigators studied viral sequences from CSF and plasma in a group of patients on ART.

Single-genome sequencing of HIV was attempted on CSF samples from 17 patients who had suppressed plasma viral loads; amplicons for sequencing were generated for 8 of the 17 patients. The CSF viral sequences were compared with sequences of HIV obtained from plasma samples from the same eight patients. In addition, virus…