Evaluation of cerebrospinal fluid virological escape in patients on long-term protease inhibitor monotherapy

Arenas-Pinto, Alejandro, Stohr, Wolfgang, Clarke, Amanda, Williams, Ian, Beeching, Nicholas J ORCID: 0000-0002-7019-8791, Minton, Jane, Lee, Vincent and Paton, Nicholas I (2017) Evaluation of cerebrospinal fluid virological escape in patients on long-term protease inhibitor monotherapy. ANTIVIRAL THERAPY, 22 (6). pp. 535-538.

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Official URL: http://dx.doi.org/10.3851/imp3146

Abstract

<h4>Background</h4>A strategy of protease inhibitor (PI) monotherapy with re-introduction of triple therapy in those who rebound has been shown to be a safe and effective treatment simplification approach for long-term management. We sought evidence for cerebrospinal fluid (CSF) virological escape in patients on long-term PI monotherapy.<h4>Methods</h4>We performed lumbar puncture in asymptomatic participants with suppressed plasma HIV RNA after 96 weeks on the PI monotherapy arm (PI-mono) of the PIVOT trial. We also report CSF HIV RNA concentration in trial participants who were investigated for neurological/neurocognitive symptoms during the trial regardless of study arm allocation.<h4>Results</h4>All 11 asymptomatic participants on PI-mono who were tested had undetectable CSF HIV RNA at week 96. One of the three symptomatic participants on PI-mono had CSF HIV RNA of 1,895 copies/ml (undetectable in plasma) and neither of two symptomatic participants on triple therapy had CSF HIV RNA detected.<h4>Conclusions</h4>CSF virological escape appears rare in asymptomatic patients on PI monotherapy and may not warrant routine CSF monitoring, but patients with symptoms merit more concern.

Item Type:	Article
Uncontrolled Keywords:	Protease Inhibitor monotherapy Versus Ongoing Triple therapy (PIVOT) CNS sub-study Team, Cerebrospinal Fluid, Humans, HIV Infections, RNA, Viral, HIV Protease Inhibitors, Treatment Outcome, Antiretroviral Therapy, Highly Active, Viral Load, Time Factors, Female
Depositing User:	Symplectic Admin
Date Deposited:	26 Feb 2020 11:37
Last Modified:	19 Jan 2023 00:00
DOI:	10.3851/IMP3146
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3076734