Presence of mutation conferring resistance to lamivudine in plasma and cerebrospinal fluid of HIV-1-infected patients.
To explore the relation between levels of HIV-1 in the cerebrospinal fluid (CSF) and plasma, simultaneously obtained samples from twelve patients who were receiving or had received lamivudine were examined. HIV-1 RNA levels were measured by nucleic acid sequence-based amplification procedure (NASBA). HIV-1 pol gene was amplified and sequenced. Median plasma and CSF HIV-1 RNA levels were 4.98 log and 2.93 log respectively. In total, 5 patients had CSF levels <100 copies/ml. A significant correlation between plasma and CSF HIV-1 RNA levels was found; 3 patients with disproportionately elevated CSF HIV-1 RNA levels had clinical evidence of central nervous system disease. Genotypic analysis was available for 9 plasma/CSF pairs. In 4, the lamivudine (3TC)-resistance mutation M184V was found in both CSF and plasma. Discordance was found in 2 pairs. In both, M184V was found in plasma but not CSF. These data suggest that CSF and plasma levels of HIV-1 may be correlated.
Chien
J W
JW
University Hospitals of Cleveland and Case Western Reserve University Center for AIDS Research, Ohio 44106-5083, USA.
Valdez
H
H
McComsey
G
G
McClernon
D
D
St Clair
M
M
Lederman
M M
MM
D019380:Anti-HIV Agents / Q000494:pharmacology*; D004352:Drug Resistance, Microbial / Q000235:genetics; D015751:Genes, pol; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology*; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics
D019380:Anti-HIV Agents; D012367:RNA, Viral; D019259:Lamivudine; D054303:HIV Reverse Transcriptase