Neurosymptomatic Cerebrospinal Fluid Escape Is a Central Nervous System-Focused Form of Antiretroviral Therapy Treatment Failure.

ABSTRACT:

Background

During antiretroviral therapy, people with HIV-1 (PWH) occasionally present with new symptoms and signs of central nervous system (CNS) injury accompanied by higher HIV-1 RNA levels in cerebrospinal fluid (CSF) than in blood, a condition defined as neurosymptomatic CSF escape (NSE). PWH meeting these general criteria but with plasma HIV-1 RNA levels >500 copies/mL have typically been assumed to be experiencing systemic treatment failure without special consideration for HIV-1 dynamics in the CNS. Thus, people with CNS-focused treatment failure may receive suboptimal treatment, targeted at controlling replication in the periphery, not the CNS.

Methods

We genetically and phenotypically characterized HIV-1 RNA in the CSF and blood of PWH (N = 9) undergoing ant

SUBMITTER: Kincer LP 

PROVIDER: S-EPMC12760783 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature