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Evaluation of CSF virological escape in patients on long-term PI monotherapy

Arenas-Pinto, A; Stöhr, W; Clarke, A; Williams, I; Beeching, NJ; Minton, J; Lee, V; (2017) Evaluation of CSF virological escape in patients on long-term PI monotherapy. Antiviral Therapy , 22 pp. 535-538. 10.3851/IMP3146. Green open access

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Abstract

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. 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. RESULTS: All 11 asymptomatic participants on PI-mono who were tested had undetectable CSF HIV-RNA at week 96. One of the 3 symptomatic participants on PI-mono had CSF HIV-RNA of 1895 copies/mL (undetectable in plasma), and neither of 2 symptomatic participants on triple therapy had CSF HIV-RNA detected. 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.

Type: Article
Title: Evaluation of CSF virological escape in patients on long-term PI monotherapy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.3851/IMP3146
Publisher version: http://dx.doi.org/10.3851/IMP3146
Language: English
Additional information: Copyright © Nucleus Global 2017.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1545073
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