Abstract
Objective: To determine the effectiveness of antiretroviral therapy in controlling cerebrospinal fluid (CSF) HIV-1 replication and to assess factors related to virological response in advanced patients. Design: A cross-sectional and longitudinal study. Methods: Consecutive paired CSF and plasma samples from HIV-1-infected patients were collected before starting or changing highly active antiretroviral therapy (HAART). Results: In the cross-sectional analysis 75 patients were included, 55 (73%) with neurological disease, 28 (37%) naive for antiretroviral agents. A significant correlation between plasma and CSF levels at baseline was observed only in antiretroviral-experienced patients. The absence of neurological disease, lower plasma HIV-1 load and a previous exposure to indinavir were all associated with a baseline CSF HIV-1-RNA level less than 80 copies/ml at multivariate analysis. In 29 patients included in the longitudinal study a significant reduction in CSF HIV-1 RNA was observed. Plasma HIV-1-RNA change, CSF HIV-1-RNA level at baseline, overall months of antiretroviral treatment and the magnitude of difference between plasma and CSF HIV-1-RNA levels were all correlated to CSF HIV-1-RNA change during treatment. A significant difference in the magnitude of CSF HIV-1-RNA reduction was observed according to naive status and to the use of three or more drugs penetrating the blood-brain barrier. Conclusion: HAART effectively reduces HIV-1 replication in CSF. A variable response to antiretroviral therapy was observed in CSF, reflecting a different compartmentalization of infection during treatment. Naive status and the use of CNS-penetrating drugs substantially enhance antiviral response. A negative interaction between virological response and the duration of antiretroviral treatment suggests long-term selection of drug-resistant CSF HIV-1 strains.
| Original language | English |
|---|---|
| Pages (from-to) | 1867-1876 |
| Number of pages | 10 |
| Journal | AIDS (London, England) |
| Volume | 16 |
| Issue number | 14 |
| DOIs | |
| Publication status | Published - Sep 27 2002 |
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Keywords
- AIDS
- Cerebrospinal fluid
- Highly active antiretroviral therapy
- HIV
- HIV-1 RNA
ASJC Scopus subject areas
- Immunology
- Immunology and Allergy
Cite this
Factors influencing virological response to antiretroviral drugs in cerebrospinal fluid of advanced HIV-1-infected patients. / Antinori, Andrea; Giancola, Maria Letizia; Grisetti, Susanna; Soldani, Fabio; Alba, Lucia; Liuzzi, Giuseppina; Amendola, Alessandra; Capobianchi, Maria; Tozzi, Valerio; Perno, Carlo Federico.
In: AIDS (London, England), Vol. 16, No. 14, 27.09.2002, p. 1867-1876.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors influencing virological response to antiretroviral drugs in cerebrospinal fluid of advanced HIV-1-infected patients
AU - Antinori, Andrea
AU - Giancola, Maria Letizia
AU - Grisetti, Susanna
AU - Soldani, Fabio
AU - Alba, Lucia
AU - Liuzzi, Giuseppina
AU - Amendola, Alessandra
AU - Capobianchi, Maria
AU - Tozzi, Valerio
AU - Perno, Carlo Federico
PY - 2002/9/27
Y1 - 2002/9/27
N2 - Objective: To determine the effectiveness of antiretroviral therapy in controlling cerebrospinal fluid (CSF) HIV-1 replication and to assess factors related to virological response in advanced patients. Design: A cross-sectional and longitudinal study. Methods: Consecutive paired CSF and plasma samples from HIV-1-infected patients were collected before starting or changing highly active antiretroviral therapy (HAART). Results: In the cross-sectional analysis 75 patients were included, 55 (73%) with neurological disease, 28 (37%) naive for antiretroviral agents. A significant correlation between plasma and CSF levels at baseline was observed only in antiretroviral-experienced patients. The absence of neurological disease, lower plasma HIV-1 load and a previous exposure to indinavir were all associated with a baseline CSF HIV-1-RNA level less than 80 copies/ml at multivariate analysis. In 29 patients included in the longitudinal study a significant reduction in CSF HIV-1 RNA was observed. Plasma HIV-1-RNA change, CSF HIV-1-RNA level at baseline, overall months of antiretroviral treatment and the magnitude of difference between plasma and CSF HIV-1-RNA levels were all correlated to CSF HIV-1-RNA change during treatment. A significant difference in the magnitude of CSF HIV-1-RNA reduction was observed according to naive status and to the use of three or more drugs penetrating the blood-brain barrier. Conclusion: HAART effectively reduces HIV-1 replication in CSF. A variable response to antiretroviral therapy was observed in CSF, reflecting a different compartmentalization of infection during treatment. Naive status and the use of CNS-penetrating drugs substantially enhance antiviral response. A negative interaction between virological response and the duration of antiretroviral treatment suggests long-term selection of drug-resistant CSF HIV-1 strains.
AB - Objective: To determine the effectiveness of antiretroviral therapy in controlling cerebrospinal fluid (CSF) HIV-1 replication and to assess factors related to virological response in advanced patients. Design: A cross-sectional and longitudinal study. Methods: Consecutive paired CSF and plasma samples from HIV-1-infected patients were collected before starting or changing highly active antiretroviral therapy (HAART). Results: In the cross-sectional analysis 75 patients were included, 55 (73%) with neurological disease, 28 (37%) naive for antiretroviral agents. A significant correlation between plasma and CSF levels at baseline was observed only in antiretroviral-experienced patients. The absence of neurological disease, lower plasma HIV-1 load and a previous exposure to indinavir were all associated with a baseline CSF HIV-1-RNA level less than 80 copies/ml at multivariate analysis. In 29 patients included in the longitudinal study a significant reduction in CSF HIV-1 RNA was observed. Plasma HIV-1-RNA change, CSF HIV-1-RNA level at baseline, overall months of antiretroviral treatment and the magnitude of difference between plasma and CSF HIV-1-RNA levels were all correlated to CSF HIV-1-RNA change during treatment. A significant difference in the magnitude of CSF HIV-1-RNA reduction was observed according to naive status and to the use of three or more drugs penetrating the blood-brain barrier. Conclusion: HAART effectively reduces HIV-1 replication in CSF. A variable response to antiretroviral therapy was observed in CSF, reflecting a different compartmentalization of infection during treatment. Naive status and the use of CNS-penetrating drugs substantially enhance antiviral response. A negative interaction between virological response and the duration of antiretroviral treatment suggests long-term selection of drug-resistant CSF HIV-1 strains.
KW - AIDS
KW - Cerebrospinal fluid
KW - Highly active antiretroviral therapy
KW - HIV
KW - HIV-1 RNA
UR - http://www.scopus.com/inward/record.url?scp=0037183960&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037183960&partnerID=8YFLogxK
U2 - 10.1097/00002030-200209270-00003
DO - 10.1097/00002030-200209270-00003
M3 - Article
C2 - 12351946
AN - SCOPUS:0037183960
VL - 16
SP - 1867
EP - 1876
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 14
ER -