title: Cerebrospinal fluid HIV-1 infection usually responds well to antiretroviral treatment.
abstract: The primary objective of this retrospective study was to determine how many patients in routine practice who were treated with combination antiretroviral treatment reached HIV-1 RNA levels below 50-400 copies/ml in cerebrospinal fluid (CSF). Seventy-four antiretroviral-naive HIV-1-infected patients from five different centres in Germany, Italy, Sweden and the USA were included. Thirty-nine percent of the patients had a HIV-1-associated neurological disease and 53% of the patients had AIDS. HIV-1 RNA in CSF and plasma were quantified before and after approximately 3 months of treatment. At baseline, the median value of HIV-1 RNA in CSF was 4.12 log copies/ml (interquartile range (IQR): 3.28-4.85) and it decreased to < 1.70 log copies/ml (IQR: < 1.70-2.48; P < 0.001) after in median 3 months of treatment. Seventy-six percent of the patients had HIV-1 RNA levels below the limits of detection in CSF at follow-up, and 85% reached below 400 copies/ml. In plasma, 45% of the patients had levels of HIV-1 RNA below the limits of detection at follow-up and 80% reached below 400 copies/ml. The group of patients with a neurological disease had a significantly higher CSF viral load both at baseline and at follow-up compared with the neurologically asymptomatic patients. We conclude that the central nervous system (CNS) is usually not a 'sanctuary site', difficult to reach with combination antiretroviral treatment.
authors.affiliation: Department of Infectious Diseases, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden asa_mellgren@yahoo.com
authors.forename: Asa
authors.initials: A
authors.lastname: Mellgren
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
authors.forename: Paola
authors.initials: P
authors.lastname: Cinque
authors.forename: Richard W
authors.initials: RW
authors.lastname: Price
authors.forename: Christian
authors.initials: C
authors.lastname: Eggers
authors.forename: Lars
authors.initials: L
authors.lastname: Hagberg
authors.forename: Magnus
authors.initials: M
authors.lastname: Gisslén
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors