{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:32:26Z","timestamp":1791919946835,"version":"4.3.4"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chongqing Science and Health Joint Medical Research Project","award":["2022MSXM033"],"award-info":[{"award-number":["2022MSXM033"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Cerebrospinal fluid (CSF) human immunodeficiency virus-1 (HIV-1) ribonucleic acid (RNA) at higher levels than in plasma has been observed in HIV-1-positive patients and defined as CSF\/plasma discordance or CSF escape. Discordance is particularly seen in untreated patients with antiretroviral agents. Quantitative data regarding its association with blood\u2013brain barrier (BBB) damage and intracranial co-infection with other pathogens are limited. Therefore, we used the CSF to plasma HIV-1 RNA ratio (HRR) to determine its relation to central nervous system (CNS) co-infection in HIV-1-positive treatment-na\u00efve individuals. We retrospectively recruited the subjects with HIV-1-positive and potential neurological deficits. A lumbar puncture was performed before the antiretroviral therapy. The paired CSF\/plasma HIV-1 RNA samples were analyzed. Univariate and multivariate logistic regression models and multiple spine regression analyses were performed to assess the association between the HRR and CNS co-infection. A total of 195 patients with 78% males (median age: 49 years) were included in this study, of whom 98 (50.2%) had CNS co-infection with other pathogens. The receiver-operating characteristic curve analysis showed that the optimal cutoff value for the HRR to predict the CNS co-infection was 1.00. Higher HRR (\u22651) was significantly associated with tuberculous meningitis (OR 6.50, 95% CI 2.08\u201320.25, p = 0.001), cryptococcus meningitis (OR 7.58, 95% CI 2.10\u201327.32, p = 0.001), and multiple co-infection (OR 4.04, 95% CI 1.02\u201316.04, p = 0.047). Higher HRR (\u22651) (OR 3.01, 95% CI 1.09\u20138.73, p = 0.032) was independently associated with the CNS co-infection after adjusting for covariates. No significant nonlinear association was found between the HRR and CNS co-infection in the multivariate spline regression (p &gt; 0.05) and a positive relationship was found between the HRR and CNS co-infection when the HRR was \u22650.78. Higher HRR was associated with an increased risk of CNS co-infection in HIV-1-positive patients. The relationship between the HRR and CNS co-infection may be related to the BBB disturbance and warrants further investigation with a large, longitudinal cohort.<\/jats:p>","DOI":"10.3390\/brainsci12060791","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T01:48:12Z","timestamp":1655430492000},"page":"791","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of High Ratio of CSF\/Plasma HIV-1 RNA with Central Nervous System Co-Infection in HIV-1-Positive Treatment-Naive Patients"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1926-4511","authenticated-orcid":false,"given":"Qian","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendan","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1212\/WNL.54.4.927","article-title":"Cerebrospinal fluid HIV RNA originates from both local CNS and systemic sources","volume":"54","author":"Ellis","year":"2000","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/COH.0b013e32835fc601","article-title":"Where does HIV hide? 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