Cerebrospinal fluid viral breakthrough in two HIV-infected subjects on darunavir/ritonavir monotherapy

被引：17
作者：
Gisslen, Magnus [1 ]
Fuchs, Dietmar [2 ]
Hagberg, Lars [1 ]
Svennerholm, Bo [3 ]
Zetterberg, Henrik [4 ,5 ]
机构：
[1] Univ Gothenburg, Dept Infect Dis, Gothenburg, Sweden
[2] Innsbruck Med Univ, Div Biol Chem, Bioctr, Innsbruck, Austria
[3] Univ Gothenburg, Dept Virol, Gothenburg, Sweden
[4] Univ Gothenburg, Dept Neurochem, Gothenburg, Sweden
[5] UCL Inst Neurol, London, England
来源：
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES | 2012年 / 44卷 / 12期
关键词：
HIV; cerebrospinal fluid; darunavir; monotherapy; neuronal injury; SUPPRESSIVE ANTIRETROVIRAL THERAPY; NEUROFILAMENT PROTEIN NFL; AIDS DEMENTIA COMPLEX; NEUROCOGNITIVE DISORDERS; TRIAL;
D O I：
10.3109/00365548.2012.690526
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
Darunavir/ritonavir monotherapy maintains HIV suppression in most patients who have achieved an undetectable viral load on combination antiretroviral treatment, and is increasingly used in the clinic. However, concerns have been raised about the effectiveness of ritonavir-boosted protease inhibitor (PI/r) monotherapy in the prevention of HIV replication in the central nervous system (CNS). Here we report the cases of 2 patients on darunavir/r maintenance monotherapy with cerebrospinal fluid viral breakthrough together with increased immunoactivation and biomarker signs of neuronal injury. These 2 cases raise concerns about the effectiveness of darunavir/ritonavir monotherapy in HIV CNS infection. Thus, we recommend caution with protease inhibitor monotherapy until CNS results have been obtained from clinical studies.
引用
收藏
页码：997 / 1000
页数：4
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