title: Relation of cerebrospinal fluid/plasma HIV-RNA discordance with neurocognitive impairment.
abstract: Neurological involvement is common in patients infected with HIV. The effectiveness of antiretroviral drugs in lowering the levels of HIV-RNA in cerebrospinal fluid (CSF) is limited by their inability to cross the blood-brain barrier. Discordance in CSF/plasma HIV-RNA levels may have a bearing on the progression of neurological disease in these patients. We report a woman with subacute neurocognitive impairment and abnormal findings on brain MRI, in whom there was a discordance between CSF/plasma HIV-RNA levels. The patient improved after a change in her highly active antiretroviral therapy (HAART) regimen. We also reviewed the available literature on the subject and found seven articles describing 27 patients.
authors.affiliation: Department of Neuroinfectology, Instituto Nacional de Neurología y Neurocirugía, Insurgente sur #3877, CP14269, Mexico City, Mexico.
authors.forename: Graciela
authors.initials: G
authors.lastname: Cárdenas
authors.affiliation: Department of Neuroinfectology, Instituto Nacional de Neurología y Neurocirugía, Insurgente sur #3877, CP14269, Mexico City, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: López-González
authors.affiliation: Department of Neuroinfectology, Instituto Nacional de Neurología y Neurocirugía, Insurgente sur #3877, CP14269, Mexico City, Mexico.
authors.forename: J F
authors.initials: JF
authors.lastname: Monzón-Falconi
authors.affiliation: Department of Neuroinfectology, Instituto Nacional de Neurología y Neurocirugía, Insurgente sur #3877, CP14269, Mexico City, Mexico.
authors.forename: J L
authors.initials: JL
authors.lastname: Soto-Hernández
authors.affiliation: Department of Infectious Diseases, Instituto Nacional de Cancerología, Av. San Fernando #22, CP14080, Mexico City, Mexico.
authors.forename: D
authors.initials: D
authors.lastname: Perales-Martínez
authors.affiliation: Department of Infectious Diseases, Instituto Nacional de Cancerología, Av. San Fernando #22, CP14080, Mexico City, Mexico.
authors.forename: C
authors.initials: C
authors.lastname: López-Vejar
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D002555:Cerebrospinal Fluid / Q000187:drug effects / Q000821:virology; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy; D018450:Disease Progression; D000068679:Emtricitabine / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D010949:Plasma / Q000187:drug effects / Q000821:virology; D012367:RNA, Viral; D019438:Ritonavir / Q000008:administration & dosage; D019258:Saquinavir / Q000008:administration & dosage; D000068698:Tenofovir / Q000008:administration & dosage; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D000068698:Tenofovir; D000068679:Emtricitabine; D019258:Saquinavir; D019438:Ritonavir