Cerebrospinal Fluid Viral Loads Reach Less than 2 Copies/ML in HIV-1-Infected Patients with Effective Antiretroviral Therapy

BACKGROUND: A low-grade persisting viraemia despite long-term treatment with highly active antiretroviral therapy (HAART) has previously been demonstrated in HIV-1-infected patients. Whether ongoing viral replication also could be detected in cerebrospinal fluid (CSF) in those circumstances has not been studied before. METHODS: Paired CSF and blood samples from 13 neurologically asymptomatic HIV-1-infected patients on stable HAART were analysed regarding HIV-1 RNA, by using a PCR assay with a detection limit of 2 copies/ml. RESULTS: All 13 patients had HIV-1 RNA < 2 copies/ml in CSF, compared with 8/13 in plasma. CONCLUSION: We could not demonstrate any persistent viral replication in the CSF of neurologically asymptomatic HIV-1-infected patients on effective HAART, rendering it unlikely that CSF acts as a viral reservoir in this category of patients.