Cerebrospinal fluid HIV RNA and drug levels with combination ritonavir and saquinavir.

摘要: UNLABELLED Combination antiretroviral therapy with ritonavir and saquinavir has established potent durable activity on plasma viremia. CNS HIV infection may be sequestered from drug that does not penetrate the blood-brain barrier. Penetration of these protease inhibitors into cerebrospinal fluid (CSF) CSF RNA levels such been well described. DESIGN/METHODS In a cross-sectional study, 28 HIV1-infected study subjects were evaluated either before initiation or maximal response to ritonavir-saquinavir therapy, during virologic response, after failure. Simultaneous samples obtained 24 measure inhibitor levels. RESULTS Across treatment groups, strong correlation was found between (r = 0.870; p < .001). each subject below assay limit (80 copies/ml), level also quantitation. Low (<2 ng/ml) (<25 in observed, CSF:plasma concentration ratio 0.005 (0.5%) all (n 11). The plasma:CSF high early (median, 38; interquartile range [IQR], 13,97), but low 0.29; IQR, 0.17, 7.5) those failing (group C, CONCLUSIONS are consistent estimated known fraction unbound (<2%). suppression viremia can predict This represent transport equilibrium plasma, it anti-HIV inhibitors. inverted compared breakthrough suggests failure contribute response.