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The effect on human immunodeficiency virus type 1 RNA levels in cerebrospinal fluid after initiation of zidovudine or didanosine

Journal article
Authors Magnus Gisslén
Gunnar Norkrans
Bo Svennerholm
Lars Hagberg
Published in J Infect Dis
Volume 175
Issue 2
Pages 434-7
Publication year 1997
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Laboratory Medicine, Dept of Clinical Virology
Pages 434-7
Language en
Keywords Adult, Aged, Anti-HIV Agents/*therapeutic use, Biopterin/analogs & derivatives/analysis, Didanosine/*therapeutic use, HIV Infections/blood/cerebrospinal fluid/*drug therapy, HIV-1/*growth & development, Humans, Middle Aged, Neopterin, RNA, Viral/*analysis, *Viral Load, Zidovudine/*therapeutic use, beta 2-Microglobulin/analysis
Subject categories Microbiology in the medical area


Human immunodeficiency virus type 1 (HIV-1) RNA, neopterin, and beta2-microglobulin levels were analyzed in cerebrospinal fluid (CSF) and serum before and 3-13 months after initiation of antiretroviral monotherapy in 16 HIV-1-infected persons. Twenty-one treatment periods, 13 after initiation of zidovudine and 8 after initiation of didanosine, were studied. During zidovudine treatment, CSF HIV RNA levels decreased by a mean of 1.05 log10 (-91%, P < .01), and CSF neopterin and beta2-microglobulin levels by 57% and 33%, respectively (P < .01). No reduction was seen during didanosine treatment in CSF HIV RNA (+0.13 log10, not significant), CSF neopterin, or beta2-microglobulin levels. Changes in CSF HIV RNA levels correlated with changes in CSF neopterin and beta2-microglobulin (r(s) = .81 and .83, respectively, P < .001). The decrease in HIV RNA was significantly larger in CSF than in serum following zidovudine treatment (P < .01). These data demonstrate that zidovudine is a potent reducer of central nervous system virus load, which may be important for long-term neuroprotection.

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