期刊
ANTIVIRAL THERAPY
卷 22, 期 6, 页码 535-538出版社
INT MEDICAL PRESS LTD
DOI: 10.3851/IMP3146
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资金
- Janssen Cilag Ltd.
- National Institute for Health Research Health Technology Assessment programme [06/403/90]
- Medical Research Council [MC_UU_12023/23] Funding Source: researchfish
- National Institute for Health Research [06/403/501] Funding Source: researchfish
- Public Health Agency [SPI/3915/08] Funding Source: researchfish
Background: 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.& para;& para;Methods: 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.& para;& para;Results: 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.& para;& para;Conclusions: 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.
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