Treatment with Abbott Laboratories' Norvir (ritonavir) and Hoffmann-LaRoche's Invirase (saquinavir mesylate) resulted in undetectable levels of HIV (less than 400 copies/mL) in the cerebrospinal fluid of patients, according to data reported at ICAAC.
The data come from an open-label study which randomized 141 protease inhibitor-naive HIV-positive patients to one of four different treatment arms. After 48 weeks, 90% of the 109 evaluable patients had undetectable plasma HIV RNA (less than 200 copies/mL). 13 patients who experienced this level of viral suppression after 60 weeks had CSF analysis performed and 12 had undetectable HIV RNA in their CSF (less than 400 copies/mL).
Brain A Viral Sanctuary? Although the clinical significance of virus levels in CSF is unknown, another studydiscussed the relationship between CSF and the severity of AIDS-related dementia. Justin McArthur, professor of neurology at Johns Hopkins University, studied 207 HIV-positive patients and found that virus levels in the CSF were significantly higher amongst those with AIDS-related dementia. These data suggest that the virus has a causal role in the development of this condition, he said. Most available drugs for HIV infection suffer from very poor central nervous system penetration.
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