Impact of combination antiretroviral therapy on cerebrospinal fluid HIV RNA and neurocognitive performance

• DOI: 10.1097/qad.0b013e32832c4152
• Publication Date: 2009-06-29T07:22:54Z
• Authors: Christina M Marra; Yu Zhao; David B Clifford; Scott Letendre; Scott Evans; Katherine Henry; Ronald J Ellis; Benigno Rodriguez; Robert W Coombs; Giovanni Schifitto; Justin C McArthur; Kevin Robertson
• Keywords: Neurocognitive; Regimen

To determine whether antiretroviral regimens with good central nervous system (CNS) penetration control HIV in cerebrospinal fluid (CSF) and improve cognition.Multisite longitudinal observational study.Research clinics.One hundred one individuals advanced beginning or changing a new potent regimen were enrolled the study. Data for 79 participants analyzed. Participants underwent structured history neurological examination, venipuncture, lumbar puncture, neuropsychological tests at entry, 24, 52 weeks.Antiretroviral categorized as CNS effectiveness (CPE) rank of least 2 less than 2. Generalized estimating equations used to examine associations over course study.Concentration RNA CSF blood test scores (NPZ4 NPZ8).Odds suppression higher when CPE was it Odds plasma not associated rank. Among impaired performance those prescribed more antiretrovirals had lower composite NPZ4 study.Antiretroviral penetration, assessed by rank, are effective controlling (and presumably CNS) viral replication poorer penetration. In this study, neurocognitive performance. A larger controlled trial is required before any conclusions regarding influence specific on should be made.