{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:58:13Z","timestamp":1790776693932,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI164566"],"award-info":[{"award-number":["UM1AI164566"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The extent and significance of subclinical cerebrospinal fluid (CSF) HIV-1 RNA detectability in adolescents with perinatally acquired HIV on long-term antiretroviral therapy (ART) are uncertain. We assessed CSF HIV-1 RNA, immunoglobulin G (IgG), and oligoclonal bands (OCBs) to explore CSF viral RNA detectability and associated immune activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an exploratory cross-sectional study of 40 adolescents aged 15\u201319 years with perinatally acquired HIV on long-term ART. Paired plasma and CSF samples were analyzed for HIV-1 RNA, CSF IgG, and OCBs. CSF viral escape was defined as detectable CSF HIV-1 RNA with concurrent plasma RNA &amp;lt;20\u2005copies\/mL. Correlations used Spearman's tests, and receiver operating characteristic analysis evaluated plasma thresholds predicting CSF detectability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-eight participants were included; 26\/38 (68%) had plasma suppression. CSF viral escape occurred in 2\/26 (7.7%) suppressed participants. Plasma and CSF viral loads correlated strongly (\u03c1 = 0.87; P &amp;lt; .0001). ROC analysis showed an area under the curve of 0.93, with a plasma threshold of 24\u2005copies\/mL for CSF detectability. CSF IgG correlated with CSF HIV RNA (\u03c1 = 0.46; P = .005). OCBs were type 1 in 70%, with type 4 mirror patterns more frequent at higher plasma viral loads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low-level CSF HIV-1 RNA was detectable in a minority of adolescents on long-term ART, including two with suppressed plasma viral load. Plasma and CSF HIV-1 RNA levels were strongly correlated. CSF IgG and OCB patterns may provide exploratory markers of immune activity, but these findings do not establish ongoing CNS viral replication or compartmentalized infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag485","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:27:45Z","timestamp":1790335665000},"source":"Crossref","is-referenced-by-count":0,"title":["Cerebrospinal Fluid Findings in Asymptomatic Adolescents on Long-term Antiretroviral Therapy After Perinatally Acquired HIV: An Exploratory Cross-sectional Study"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5007-0580","authenticated-orcid":false,"given":"S","family":"Surendran-Nair","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Otwombe","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Josipovic","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Violari","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C T","family":"Tiemessen","sequence":"additional","affiliation":[{"name":"Centre for HIV and STIs, National Institute for Communicable Diseases, A Division of the National Health Laboratory Service , Johannesburg ,","place":["South Africa"]},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Laughton","sequence":"additional","affiliation":[{"name":"Family Centre for Clinical Research with Ubuntu, Department of Paediatrics and Child Health, Tygerberg Academic Hospital, Stellenbosch University , Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M F","family":"Cotton","sequence":"additional","affiliation":[{"name":"Family Centre for Clinical Research with Ubuntu, Department of Paediatrics and Child Health, Tygerberg Academic Hospital, Stellenbosch University , Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Mochan","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2026093009172786200_ofag485-B1","author":"Organisation WH"},{"key":"2026093009172786200_ofag485-B2","author":"UNAIDS"},{"key":"2026093009172786200_ofag485-B3","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/COH.0000000000000293","article-title":"Tissue reservoirs of HIV","volume":"11","author":"Wong","year":"2016","journal-title":"Curr Opin HIV 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