HIV-1 compartmentalization in the central nervous system during cryptococcal meningitis: Analysis of viral, fungal, and host factors.

HIV-1 compartmentalization between blood and cerebrospinal fluid occurs in PWH with cryptococcal meningitis, with some populations reaching over 10^5 copies/ml in CSF.

• Why it matters: Understanding how opportunistic infections like cryptococcal meningitis influence HIV-1 populations in the CNS is crucial for managing neuroinflammation and viral persistence in PWH.
• What they did: The study analyzed paired plasma and CSF samples from 39 PWH with CM, characterizing HIV-1 env populations in 18 individuals, and assessed viral loads, coreceptor usage, and cytokine levels pre-ART.
• The result: Viral compartmentalization was observed in both groups, associated with higher CSF IL-2 levels, and included macrophage-tropic populations; post-ART, distinct HIV-1 populations emerged, indicating diverse effects of opportunistic infections on viral evolution.