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Blood brain barrier impairment is associated with cerebrospinal fluid markers of neuronal damage in HIV-positive patients

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Abstract

Blood brain barrier impairment occurs early in the course of infection by HIV and it may persist in a subset of patients despite effective antiretroviral treatment. We tested the hypothesis that HIV-positive patients with dysfunctional blood brain barrier may have altered biomarkers of neuronal damage. In adult HIV-positive highly active antiretroviral treatment (HAART)-treated patients (without central nervous system infections and undergoing lumbar punctures for clinical reasons) cerebrospinal fluid albumin to serum ratios (CSAR), total tau, phosphorylated tau, 1–42 beta amyloid, and neopterin were measured. In 101 adult patients, cerebrospinal fluid-to-serum albumin ratios were 4.8 (3.7–6.1) with 12 patients (11.9 %) presenting age-defined impaired blood brain barrier. A significant correlation was observed between CSAR and total tau (p = 0.005), phosphorylated tau (p = 0.008), and 1–42 beta amyloid (p = 0.040). Patients with impaired blood brain barrier showed significantly higher total tau (201.6 vs. 87.3 pg/mL, p = 0.010), phosphorylated tau (35.3 vs. 32.1 ng/mL, p = 0.035), and 1–42 beta amyloid (1134 vs. 830 pg/mL, p = 0.045). Despite effective antiretroviral treatment, blood brain barrier impairment persists in some HIV-positive patients: it is associated with markers of neuronal damage and it was not associated with CSF neopterin concentrations.

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Acknowledgements

We thank our patients and their families.

Conflicts of interest

The authors declare that they have no conflict of interest. AC has received honoraria from Abbvie, BMS, Gilead, Janssen-Cilag, MSD, Viiv, and he is currently receiving research grants from BMS and Gilead. GDP and SB have received honoraria from Abbvie, BMS, Gilead, Janssen-Cilag, MSD, Viiv.

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Authors and Affiliations

  1. Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Ospedale Amedeo di Savoia, C.so Svizzera 164, 10149, Torino, Italy

    A. Calcagno, S. Audagnotto, M. L. Stella, C. Montrucchio, G. Di Perri & S. Bonora

  2. Unit of neurology, Ospedale Maria Vittoria, ASLTO2, Torino, Italy

    C. Atzori, D. Vai & D. Imperiale

  3. Laboratory of Immunology, Ospedale Maria Vittoria, ASLTO2, Torino, Italy

    A. Romito

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  1. A. Calcagno
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  2. C. Atzori
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  3. A. Romito
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  4. D. Vai
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  5. S. Audagnotto
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  7. C. Montrucchio
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  8. D. Imperiale
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  9. G. Di Perri
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  10. S. Bonora
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Correspondence to A. Calcagno.

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Calcagno, A., Atzori, C., Romito, A. et al. Blood brain barrier impairment is associated with cerebrospinal fluid markers of neuronal damage in HIV-positive patients. J. Neurovirol. 22, 88–92 (2016). https://doi.org/10.1007/s13365-015-0371-x

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  • DOI: https://doi.org/10.1007/s13365-015-0371-x

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