Up-regulation of soluble tumor necrosis factor receptor two in plasma of HIV-seropositive individuals who use opiates.

Previously, we reported an increase in soluble tumor necrosis factor-alpha receptor two (sTNF-R2) and soluble CD14 (sCD14) in the plasma of HIV-seropositive individuals with neurocognitive dysfunction compared to their cognitively intact counterparts. As intravenous drug use is not only a risk factor for HIV but also an immunomodulator, we sought to examine the effects of drug use on soluble markers of immune activation. These relationships were investigated in 25 patients with late stage HIV-1 disease.

Plasma levels of soluble CD14 and tumor necrosis factor-alpha type II receptor correlate with cognitive dysfunction during human immunodeficiency virus type 1 infection.

The relationship between monocyte immune responses and cognitive impairment during progressive human immunodeficiency virus type 1 (HIV-1) infection was investigated in 28 subjects receiving highly active antiretroviral therapy. The mean+/-SEM CD4(+) T lymphocyte count and virus load for all patients were 237+/-41 cells/mm(3) and 77,091+/-195,372 HIV-1 RNA copies/mL, respectively. Levels of soluble tumor necrosis factor-alpha type II receptor (sTNF-RII) and soluble CD14 (sCD14) were measured in plasma by ELISA and were correlated with results from neuropsychological, magnetic resonance imaging, and magnetic resonance spectroscopy tests.

Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.

Background: Combination antiretroviral therapy with protease inhibitors has transformed HIV infection from a terminal condition into one that is manageable. However, the complexity of regimens makes adherence to therapy difficult.

Objective: To assess the effects of different levels of adherence to therapy on virologic, immunologic, and clinical outcome; to determine modifiable conditions associated with suboptimal adherence; and to determine how well clinicians predict patient adherence.