Plasma central nervous system biomarkers in heavily treatment-experienced people with HIV in the PRESTIGIO registry.

We evaluated the levels of plasma biomarkers of central nervous system (CNS) injury in people with HIV and four-class drug resistance (heavily treatment-experienced, HTE), and in virally suppressed, non-HTE controls. Biomarkers included NFL, t-Tau, GFAP, and UCH-L1. No evidence was found for higher biomarker levels in HTE individuals. Age, comorbidities, and CD4+ cell count were stronger predictors of higher biomarker levels than HTE status or viral replication. Effective management may mitigate CNS injury despite long-term HIV infection and treatment resistance.