Many individuals with HIV who are receiving antiretroviral therapy (ART) have viral genetic material in the cells of their cerebrospinal fluid (CSF), making them more likely to experience memory and concentration problems, according to the results of a new study published in the Journal of Clinical Investigation.

Investigators from the University of North Carolina, the University of Pittsburgh, and Yale University studied participants in the AIDS Clinical Trials Group HIV Reservoirs Cohort Study. They studied a primarily male group, aged 45 to 56 years, of long-term HIV survivors with infections controlled with ART for an average of 9 years. The investigators analyzed each participant’s CSF for HIV DNA and compared these data with each participant’s results from standard neurocognitive evaluations.

The authors evaluated 69 individuals on long-term ART and found that nearly half had persistent HIV in cells in their CSF, indicating the presence of latent virus, even though standard HIV RNA viral load tests of the cell-free CSF fluid were positive in only 4% of the participants. Investigators also found that 30% of this subset experienced neurocognitive difficulties compared with 11% of individuals whose CSF did not contain viral DNA.

These findings suggest that the presence of persistent HIV-infected cells in the CNS, despite long-term ART, may play a role in neurocognitive impairment.

Persistent HIV in central nervous system linked to cognitive impairment [news release]. Bethesda, MD: National Institutes of Health; July 16, 2019. Accessed September 24, 2019.