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Cerebrospinal fluid and plasma viral load in HIV-1-infected patients with various anti-retroviral treatment regimens

Journal article
Authors Magnus Gisslén
Bo Svennerholm
Gunnar Norkrans
Christer Franzén
Christer Säll
Rune Svensson
Sven Öberg
Lars Hagberg
Published in Scand J Infect Dis
Volume 32
Issue 4
Pages 365-9
Publication year 2000
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Laboratory Medicine, Dept of Clinical Virology
Pages 365-9
Language en
Keywords Acquired Immunodeficiency Syndrome/*drug therapy/virology, *Antiretroviral Therapy, Highly Active, *Hiv-1, Humans, Multivariate Analysis, RNA, Viral/blood/*cerebrospinal fluid, Retrospective Studies
Subject categories Microbiology in the medical area


Highly active anti-retroviral therapy (HAART) effectively decreases HIV-1 RNA in cerebrospinal fluid (CSF) and plasma in controlled clinical trials. To study the virological effect in CSF and plasma achieved in routine practice, HIV-1 RNA levels were analysed retrospectively in 27 patients on mono-nucleoside reversed transcriptase inhibitor (NRTI) treatment, 27 on dual-NRTI-treatment and 45 on HAART using a Roche Amplicor HIV-1 monitor quantitative PCR. A significant difference was found in the proportion of patients with a CSF viral load below 20 copies/ml between patients treated with 1 (0%) and 2 NRTIs (41%) as well as between those treated with 2 NRTIs and HAART (69%). The proportion of patients with plasma viral load below 20 copies/ml differed significantly between patients on HAART (47%) and those on 2 NRTIs (0%), but not between those with 1 (0%) or 2 NRTIs. In multivariate regression analysis, treatment regimen and prior anti-retroviral experience (but not treatment time) were independently associated with the CSF viral load. Plasma viral load was independently associated with treatment regimen and treatment time, but not with anti-retroviral experience. Dual-NRTI-treatment affects the CSF viral load substantially, while HAART is required to achieve an essential decline in plasma viral load.

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