Soluble membrane attack complex in the blood and cerebrospinal fluid of HIV-infected individuals, relationship to HIV RNA, and comparison with HIV negatives

•This is a study of the soluble membrane complex (sMAC) in CSF/plasma from 47 HIV-infected individuals as well as 11 HIV-negative individuals.•CSF sMAC was detectable at baseline in 22.7% of HIV + participants on cART compared to 0% of HIV-negative participants.•CSF sMAC levels correlated significantly with CSF HIV RNA levels.•Plasma sMAC levels declined significantly during antiretroviral therapy.•There was a negative association trend between sMAC and cognitive performance that warrants further investigation.

The soluble membrane attack complex (sMAC) represents the terminal product of the complement cascade. We enrolled 47 HIV + adults (12 of whom underwent a second visit at least 24 weeks after starting therapy) as well as 11 HIV negative controls. At baseline, cerebrospinal fluid (CSF) sMAC was detectable in 27.7% of HIV + individuals. CSF sMAC correlated with CSF HIV RNA levels and was more likely to be detectable in HIV + individuals on cART compared to HIV negative controls. In HIV + participants, there were negative association trends between sMAC and neurocognitive performance but these did not reach statistical significance.

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