Gutiérrez Catalina, Chanqueo Leonardo, Bernal Fernando, Ramírez Alejandro, Loureiro Oscar, Vásquez Patricia
Servicio de Medicina Interna, Unidad de Infectología, Chile.
Laboratorio Clínico, Chile.
Rev Chilena Infectol. 2018;35(5):601-605. doi: 10.4067/s0716-10182018000500601.
Detection of virus in cerebrospinal fluid (CSF) in HIV-infected patients with HIV viral load (VL) undetectable in plasma has been termed viral escape. These leaks may be asymptomatic from a neurological point of view, similar to plasma blips, or associated with neurological disease, with discordant VL between plasma and CSF, and may be evidence of a compartmentalization of the virus and the possibility of identifying quasispecies with mutations that confer resistance to ART. We present the case of a man with AIDS and disseminated tuberculosis who presented neurological symptomatology evidenced by headache and convulsive syndrome, who presented a discordance between plasma and CSF HIV VL; the genotypic test of the virus, obtained by lumbar puncture, identified new mutations that determined a change in ART with subsequent satisfactory evolution.
在血浆中无法检测到HIV病毒载量（VL）的HIV感染患者的脑脊液（CSF）中检测到病毒，这被称为病毒逃逸。从神经学角度来看，这些泄漏可能无症状，类似于血浆波动，或与神经疾病相关，血浆和脑脊液中的VL不一致，这可能是病毒区室化的证据，以及识别具有抗逆转录病毒治疗（ART）耐药性突变的准种的可能性。我们报告了一例患有艾滋病和播散性结核病的男性病例，该患者出现了以头痛和惊厥综合征为证据的神经症状，其血浆和脑脊液HIV VL不一致；通过腰椎穿刺获得的病毒基因分型检测发现了新的突变，这些突变决定了ART的改变，随后病情得到了令人满意的进展。
