Prevalence and risk factors for HIV CSF viral escape: Results from the CHARTER and HNRP cohorts.

Type: Poster
Title: Prevalence and risk factors for HIV CSF viral escape: Results from the CHARTER and HNRP cohorts.
Authors: PĂ©rez-Valero I, Letendre S, Ellis R, Deutsch R, Franklin D, Clifford DB, Heaton R, McCutchan J, McArthur J, Morgello S, Gelman B, Collier A, Grant I, and the CHARTER & HNRP Groups
Date: 11-11-2012
Abstract:Background: CSF viral escape (CVE), HIV-RNA >50 cop/mL in CSF while HIV-RNA <50 cop/mL in plasma, occurs despite ART. Recent reports indicate that this condition occurs in 10-15% of individuals. The true prevalence and clinical relevance of CVE, remain unclear due to the relatively small number of case series reported. Although evidence is limited, the 2012 EACS guidelines supported ART optimization with active CNS drugs when CVE is detected in presence of HIV-associated neurocognitive disorder (HAND) Objective: Determine the prevalence and the factors associated with the presence of CSF viral escape in two large US HIV cohorts: The CHARTER Cohort The HNRP Cohort at UC San Diego Conclusions: CSF viral escape is an uncommon event. Higher levels of CSF WBC, platelets and serum proteins observed in presence of CVE may reflect greater immuneactivation. PI-based ART, especially if unboosted atazanavir was used, was associated with CVE. Presence of CVE was not associated in this study with a higher risk of neurocognitive impairment. Prospective analysis are needed for a better characterization of CVE.