Abstract
OBJECTIVE: To characterize HIV-infected patients with neurosymptomatic cerebrospinal fluid (CSF) 'escape', defined as detectable CSF HIV RNA in the setting of treatment-suppressed plasma levels or CSF RNA more than 1-log higher than plasma RNA. DESIGN: Retrospective case series. SETTING: Four urban medical centers in the United States and Europe. PARTICIPANTS: Virologically controlled HIV-infected patients on antiretroviral therapy (ART) with progressive neurologic abnormalities who were determined to have CSF 'escape'. INTERVENTION: Optimization of ART based upon drug susceptibility and presumed central nervous system exposure. MAIN OUTCOME MEASURES: Levels of CSF HIV RNA and inflammatory markers, clinical signs and symptoms, and MRI findings. RESULTS: Ten patients presented with new neurologic abnormalities, which included sensory, motor, and cognitive manifestations. Median CSF HIV RNA was 3900copies/ml (range 134-9056), whereas median plasma HIV RNA was 62copies/ml (range
Original language | English |
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Pages (from-to) | 1765-1774 |
Number of pages | 10 |
Journal | AIDS (London, England) |
Volume | 26 |
Issue number | 14 |
DOIs | |
Publication status | Published - Sep 10 2012 |
Keywords
- antiretroviral therapy
- central nervous system
- cerebrospinal fluid
- HIV
- HIV drug resistance
- HIV pathogenesis
- neurologic manifestations
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases