Dual antiretroviral therapies are effective and safe regimens in the central nervous system of neurologically symptomatic people living with HIV.
CD4 Lymphocyte Count
Central Nervous System
Central Nervous System Diseases
/ virology
Cerebrospinal Fluid
/ virology
Cross-Sectional Studies
Female
HIV Infections
/ cerebrospinal fluid
HIV-1
/ drug effects
Humans
Male
Middle Aged
Neurocognitive Disorders
/ drug therapy
RNA, Viral
Retrospective Studies
Viral Load
/ drug effects
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 11 2020
01 11 2020
Historique:
pubmed:
24
7
2020
medline:
13
3
2021
entrez:
24
7
2020
Statut:
ppublish
Résumé
Aim of this study was to compare cerebrospinal fluid (CSF) virological control, biomarkers and neurocognition of neurologically symptomatic patients on dual antiretroviral therapies (dual therapy) vs. 2 nucleoside reverse transcriptase inhibitors-based three-drug regimens (triple therapy). Retrospective monocentric cross-sectional study. We analysed data from people living with HIV undergoing lumbar puncture for clinical/research reasons with plasma HIV-RNA less than 200 copies/ml and neurological/neurocognitive symptoms without significant contributing comorbidities. We measured CSF HIV-RNA, inflammation, blood-brain barrier integrity, neuronal damage and astrocytosis biomarkers (five biomarkers by ELISA and five indices by immunoturbidimetry) and recorded the neurocognitive performance (14 tests). CSF escape was defined as any case of CSF HIV-RNA 0.5 Log10 higher than viraemia or any case of detectable CSF HIV-RNA coupled with undetectable viraemia. A total of 78 patients on triple therapy and 19 on dual therapy were included. Overall, 75.3% male, median age 51 years (46-58), current CD4 count 545 cells/μl (349-735), time on current regimens 18 months (8-29), but length of plasma suppression 32 months (14-94). The two groups did not differ in terms of HIV-associated neurological diagnoses, demographic and viro-immunological features. Undetectable CSF HIV-RNA (73.7% in dual therapy vs. 78.2% in triple therapy, p.67) and CSF escape (21.1% in dual therapy vs. 19.2% in triple therapy, p.86) did not differ. No difference was observed in depression, anxiety, neurocognition (in 63 participants) nor in any tested biomarker. In people living with HIV with neurological/neurocognitive symptoms, peripherally effective dual therapy can show CSF virosuppression, inflammation, neuronal and astrocyte integrity and neurocognition comparable to triple therapy.
Identifiants
pubmed: 32701580
doi: 10.1097/QAD.0000000000002601
pii: 00002030-202011010-00006
doi:
Substances chimiques
RNA, Viral
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1899-1906Commentaires et corrections
Type : CommentIn
Références
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