{"id":5664,"date":"2006-03-25T08:01:50","date_gmt":"2006-03-25T07:01:50","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=5664"},"modified":"2013-12-07T08:10:00","modified_gmt":"2013-12-07T08:10:00","slug":"cns-penetration-of-arv-drugs-is-associated-with-lower-csf-viral-load","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/5664","title":{"rendered":"CNS penetration of ARV drugs is associated with lower CSF viral load"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>Letendre and colleagues from San Diego reported results from the Chapter Study, which assigned individual ARVs a CNS penetration index of 0 (low), 0.5 (intermediate) or 1 (high), based on published data and chemical properties (see Table 1).<\/strong><\/p>\n<p>They measured plasma and CSF viral load in 374 HIV-positive patients taking at least one ARV who were prospectively enrolled for the study.<\/p>\n<p>Results from the study showed that higher penetration scores correlated with lower CSF viral load, which remained significant in a multivariate modal that adjusted for number of ARVs used for each patient, and plasma viral load (model r2 = 0.34, p &lt;0.0001). In contrast, penetration scores did not correlate with plasma viral load (p = 0.26).<\/p>\n<p>The study concluded that better penetration of ART across the blood-CSF barrier led to better control of HIV replication in CSF and that as inhibition of HIV replication in the CNS is important in treating patients who have HIV-associated neurocognitive disorders, they may benefit from CNS-targeted ART therapy.<\/p>\n<p><strong>Table 1: Assigned CSF penetration based on published data and chemical properties<\/strong><\/p>\n<table border=\"0\">\n<tbody>\n<tr>\n<td><\/td>\n<td colspan=\"3\">Increasing CNS penetration<\/td>\n<\/tr>\n<tr>\n<td><\/td>\n<td>0<\/td>\n<td>0.5<\/td>\n<td>1.0<\/td>\n<\/tr>\n<tr>\n<td>NRTI<\/td>\n<td>TDF, ddI<\/td>\n<td>3TC, FTC, d4T<\/td>\n<td>AZT, abacavir<\/td>\n<\/tr>\n<tr>\n<td>NNRTI<\/td>\n<td><\/td>\n<td>efavirenz<\/td>\n<td>nevirapine, delavirdine<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\">PI<\/td>\n<td>nelfinavir, ritonavir<\/td>\n<td>amprenavir\/fosamprenavir<\/td>\n<td>amprenavir\/r, fosamprenavir\/r<\/td>\n<\/tr>\n<tr>\n<td>saquinavir, saquinavir\/r<\/td>\n<td>indinavir<\/td>\n<td>indinavir\/r, lopinavir\/r<\/td>\n<\/tr>\n<tr>\n<td>tipranavir\/r<\/td>\n<td>atazanavir<\/td>\n<td>atazanavir\/r<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Comment<\/h3>\n<p><strong>CSF penetration is generally more important to consider for patients with neurologic symptoms. The table on CSF penetration from one of the expert groups in this field is useful.<\/strong><\/p>\n<p>Reference:<\/p>\n<p>Letendre S, Capparelli E, Simpson D et al. Better antiretroviral penetration into the central nervous system is associated with lower CSF viral load. 13th Conference on Retroviruses and Opportunistic Infections, 5-8 February 2006, Denver, Colorado. Abstract 74.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base Letendre and colleagues from San Diego reported results from the Chapter Study, which assigned individual ARVs a CNS penetration index of 0 (low), 0.5 (intermediate) or 1 (high), based on published data and chemical properties (see &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3],"tags":[60],"class_list":["post-5664","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","tag-croi-2006"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/5664","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=5664"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/5664\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=5664"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=5664"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=5664"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}