Antiretroviral Therapy Regimens with Superior CNS Penetration Did Not Reduce Risk for HIV Dementia

Some antiretrovirals penetrate the blood-brain barrier considerably better than others, and “high-penetration” regimens, as defined by a standard central nervous system (CNS) penetration-effectiveness (CPE) score, are linked to lower cerebrospinal fluid viral loads. However, whether such regimens carry clinical benefits — specifically, a reduction in risk for HIV dementia and other HIV-associated neurologic disease — remains unclear.

To explore this issue, investigators pooled results from nine prospective cohort studies in Europe and the U.S. involving >60,000 antiretroviral-naive, HIV-infected adults without clinical AIDS who began treatment after January 1, 1998. Sixty-two percent of them started a regimen considered to have low CNS penet…