Cerebrospinal fluid and plasma viral load in HIV-1-infected patients with various anti-retroviral treatment regimens.
Highly active anti-retroviral therapy (HAART) effectively decreases HIV-1 RNA in cerebrospinal fluid (CSF) and plasma in controlled clinical trials. To study the virological effect in CSF and plasma achieved in routine practice, HIV-1 RNA levels were analysed retrospectively in 27 patients on mono-nucleoside reversed transcriptase inhibitor (NRTI) treatment, 27 on dual-NRTI-treatment and 45 on HAART using a Roche Amplicor HIV-1 monitor quantitative PCR. A significant difference was found in the proportion of patients with a CSF viral load below 20 copies/ml between patients treated with 1 (0%) and 2 NRTIs (41%) as well as between those treated with 2 NRTIs and HAART (69%). The proportion of patients with plasma viral load below 20 copies/ml differed significantly between patients on HAART (47%) and those on 2 NRTIs (0%), but not between those with 1 (0%) or 2 NRTIs. In multivariate regression analysis, treatment regimen and prior anti-retroviral experience (but not treatment time) were independently associated with the CSF viral load. Plasma viral load was independently associated with treatment regimen and treatment time, but not with anti-retroviral experience. Dual-NRTI-treatment affects the CSF viral load substantially, while HAART is required to achieve an essential decline in plasma viral load.
Gisslén
M
M
Department of Infectious Diseases, Sahlgrenska University Hospital, Göteborg, Sweden.
Svennerholm
B
B
Norkrans
G
G
Franzén
C
C
Säll
C
C
Svensson
R
R
Oberg
S
S
Hagberg
L
L
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active; D015497:HIV-1; D006801:Humans; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies
D012367:RNA, Viral