Lopinavir/r Monotherapy: Evidence of Ongoing CNS Damage, Regardless of Viral Replication

Levels of S100B and neopterin were elevated in the cerebrospinal fluid of HIV-infected patients on lopinavir/ritonavir monotherapy, with S100B elevation seen even in the absence of detectable viral loads.

Despite prolonged survival and decreased incidence of overt dementia in HIV-infected patients on suppressive antiretroviral therapy (ART), the central nervous system (CNS) can suffer ongoing damage due to immune activation, viral escape, or toxicity of the therapeutic agents. With advances in ART options and the aging of people with long-term HIV infection, potential adverse CNS effects need to be considered when choosing regimens.

To explore this, researchers evaluated cerebrospinal fluid (CSF) samples collected as part of the randomized, open-label Monotherapy Switzerland/Thailand trial of boosted lopinavir, which was terminated prematurely because of virologic failure in plasma and CSF of six patients in the lopinavir/ritonavir-monotherap…

Reviewing Authors

Jennifer L. Lyons, MD

Paul Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

Paul Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

Lopinavir/r Monotherapy: Evidence of Ongoing CNS Damage, Regardless of Viral Replication

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Reviewing Authors