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ATI and the Central Nervous System (CNS):
Introduction
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Richard W. Price, M.D.
Department of Neurology UCSF
Reported by Jules Levin
A review of potential risks associated with ATIs in cure studies provided by Richard Price on a conference call with community and researchers, shared with Dr Price's permission. Dr Price says - I don't actually know the risks, and my notes are really guesses. I suspect that the risks are actually not high, but the best thing is to try to study the issue. And this is not so easy, because of the inaccessibility of CNS to study and limited tools, and the work and funding, among other things.
There has been discussion around whether HIV accelerates brain aging, here is link orecent study published....HIV enters brain shortly within days after infection and causes inflammation & neuronal injury which persists despite suppressive ART during chronic infection. So in this context what is additional potential risk of taking an interruption brief or longer in length on the brain & brain reservoirs? That is the question. This question needs further research incorporated into cure studies AND better "Informed Consent" conceding this and other risks is required such as risk for reseeding other reservoirs; there are many reservoirs so a study finding 1 or 2 reservoirs are nor reseeded with HIV does not necessarily mean all other reservoirs are not reseeded.
HIV prematurely ages the brain - new study & Commentary - (07/19/17)
Several published studies raising concerns that an ATI - interruption - in a cure study or any interruption may incur risk of impacting the brain and the CNS, it might cause viral escape in the CNS which could lead to long term neurologic damage.
CROI: BRAIN 18F-FDG PET OF SIV-INFECTED MACAQUES AFTER TREATMENT INTERRUPTION OR INITIATION - (03/09/18) - interruption leads to hyper metabolism, maybe due to neuroinflammation which may be result of ART interruption, which were correlated with increases in CSF cytokines & decreases in CD4 & CD8...."raising concerns about the potential effects of even brief period of non-adherence to ART."
CROI: SIV REBOUND IN THE SPINAL CORD AFTER STOPPING ART: A NOVEL CNS RESERVOIR (03/09/18)
ART Interruption Associated with HIV in the Brain: "Reseeding CNS during ART Interruption Leading to Intrathecal Immune Activation" - "HIV-1 Viral Escape in Cerebrospinal Fluid of Subjects on Suppressive Antiretroviral Treatment" - (09/18/17)
Cure Studies/ART Interruption & Brain Affects, Vorinostat - (10/13/17)
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