November 14, 2007

Suppressing HIV Doesn’t Stop Immune Activation

Signs of immune over-activation has been found in the spinal fluid of volunteers who have suppressed HIV to undetectable levels for four years, according to a newly published study in the Journal of Infectious Diseases. While this did not appear to be linked to a higher risk of central nervous system problems in the patients studied, the authors suggest that ongoing immune activation may contribute to long-term brain injury.   

Arvid Edén, MD, of the department of infectious diseases at the Sahlgrenska Academy at Göteborg University in Göteborg, Sweden, and a team of researchers identified 15 patients on antiretroviral therapy who had maintained an undetectable viral load for more than three and a half years and who’d had their cerebrospinal fluid (CSF) examined by lumbar puncture. The team measured the level of HIV in the CSF as well as neopterin and IgG, which are markers of immune activation. Persistent immune activation is believed by many to be a primary factor in HIV disease progression, and in the brain a cause of brain damage.

All 15 patients maintained undetectable HIV levels for the four-year period and none had development or progression of new brain-related illnesses. Although neopterin and IgG levels also decreased overall during the same period, eight patients had abnormally high levels of both indicators at the four-year mark. Larger and longer-term studies are needed to determine if this level of immune activation could result in future signs of brain injury.

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Previous Comments:

David Evans, New York, AIDSmeds.com, 2007-11-28 16:57:25
To all - We are still learning about how HIV impacts the brain, as this study shows. In the most general sense, effective combination antiretroviral therapy has significantly reduced the incidence of HIV-related brain illnesses. HIV treatment is very good, but it's not perfect. If you have specific questions about the impact of HIV and/or your treatment on your brain you should certainly talk to your doctor.

husein, ethiopia, 2007-11-26 11:00:04
i am hiv positive i take the medications i mean the anti-retroviral pills..so i ask to those who know better than me if there newly developed and confirmed treatment better than ones we ussually in africa...i heard that in iran scientists discovered herbal medicine and many others......i wish your lively info soon.

Joe Russel, New York, 2007-11-22 16:58:41
I've been undetectable since 1996 and briefly had some neuological problems (weakness in right arm and leg) which was not diagnosed depsite many medical tests. Gradually the symptoms disappeared. In 2003 I began taking Sustiva which I believe crosses the blood/brain barrier. Could Sustiva be responsible for the absence of any further neuological symptoms?

JACQUES, Cape Town, South Africa, 2007-11-22 02:46:45
Surely this is the case if a direct link between HIV treatment and the side effect of Neuropathy has been established and treatment with Amitrip, B1 and B6 have been prescribed to fight off the Neuropathy?

Charlie Baltz, Honolulu, 2007-11-22 01:14:32
My viral load has also been "undetectable" for over 4 yrs now, and I've been positive for appoximately 7 yrs. Recently, I have experienced several incidences of short term memory loss and have been diagnosed with "chronic depression and insomnia also. My insurance coverage is also w/Kaiser.

Frank Mastrapa, , 2007-11-21 19:50:47
I have bee non-detectable for six years and now i have a disorder of my bone marow name (polycithemia vera) were your body produces to many red blood cells I wonder if this is all related

mike jones, , 2007-11-21 15:56:56
I have developed a seizure disorder after becoming HIV positive. I have been positive for about 4 years and viral load undetectable for all 4 years. Is it the overactivity of the immune system in the central nervous system that has caused my temporal lobe lesion and consequently my seizure disorder?

Tim Sanders, , 2007-11-21 10:44:38
I have had a non-detectable viral load since 1995. And although my IgG levels have fluctuated, no sign of any long term brain changes. I just had a isotopic brain scan and all areas of the brain were functioning normally. However, long term depression (not severe) and some cognitive impairment remain. Severe insomnia has been present since 1992. Perhaps my neuro transmitters are just genetically out of whack!! Anyone got any comments.

Vic Russell, San Jose, 2007-11-15 18:13:16
Sure wish someone would do studies on real long term supressed viral load. Mine hasn't been measurable in well over a decade as many being treated by Kaiser can lay claim to. They have the worlds highest survival rate in treating HIV, never understood why their model hasn;t been more widly spread..