Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain.
Infectious Diseases Service, Hospital Clinic of Barcelona, Barcelona, Spain.
J Infect Dis. 2021 Jun 4;223(11):1928-1933. doi: 10.1093/infdis/jiaa645.
A major concern of human immunodeficiency virus (HIV) dual therapy is a potentially lower efficacy in viral reservoirs, especially in the central nervous system (CNS). We evaluated HIV RNA, neuronal injury, and inflammatory biomarkers and dolutegravir (DTG) exposure in cerebrospinal fluid (CSF) in patients switching to DTG plus lamivudine (3TC). All participants maintained viral suppression in plasma and CSF at week 48. We observed no increase in CSF markers of inflammation or neuronal injury. Median (interquartile range) total and unbound DTG in CSF were 7.3 (5.9-8.4) and 1.7 (1.2-1.9) ng/mL, respectively. DTG+3TC may maintain viral control without changes in inflammatory/injury markers within the CNS reservoir.
人免疫缺陷病毒 (HIV) 双重疗法的一个主要关注点是病毒储库的疗效可能降低，尤其是在中枢神经系统 (CNS) 中。我们评估了转用多替拉韦（DTG）加拉米夫定（3TC）的患者的 HIV RNA、神经元损伤和炎症生物标志物以及脑脊液 (CSF) 中的 DTG 暴露情况。所有参与者在第 48 周时均保持血浆和 CSF 中的病毒抑制。我们未观察到 CSF 炎症或神经元损伤标志物的增加。脑脊液中总 DTG 和游离 DTG 的中位数（四分位距）分别为 7.3（5.9-8.4）和 1.7（1.2-1.9）ng/mL。DTG+3TC 可能在不改变 CNS 储库中炎症/损伤标志物的情况下维持病毒控制。
