Effect of combination antiretroviral therapy on cerebrospinal fluid HIV RNA, HIV resistance, and clinical manifestations of encephalopathy

Cynthia McCoig, Maria Mercedes Castrejón, Elizabeth Castaño, Onix De Suman, Carmen Báez, Wilfrido Redondo, Daniel McClernon, Susan Danehower, E. Randall Lanier, Carol Richardson, Amy Keller, Seth Hetherington, Xavier Sáez-Llorens, Octavio Ramilo

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Objectives: This study evaluated the effect of treatment with abacavir/lamivudine/zidovudine versus lamivudine/zidovudine on cerebrospinal fluid (CSF) human immunodeficiency virus (HIV) RNA and clinical manifestations of HIV encephalopathy in children. Study design: HIV-infected children 7 months to 10 years of age (n = 23) were studied. CSF and plasma were obtained at baseline and weeks 8, 16, and 48. Genotype analysis of HIV was attempted at baseline and week 48. Neurologic evaluations were performed at baseline and weeks 16, 32, and 48. Results: At baseline, 83% of children had >2.00 log10 copies/mL HIV RNA in CSE but only 10% had HIV RNA measurable at week 48. Among children in whom paired genotyping of HIV was possible, 8 of 11 had identical patterns in both CSF and plasma at baseline, whereas at week 48, only 1 of 9 children had similar patterns. Neurologic abnormalities were observed in 83% of children at baseline but only 35% of children at week 48 (P = .004), suggesting a benefit of treatment. Conclusions: Antiretroviral therapy was associated with a decline in CSF HIV RNA and an improvement in neurologic status. The development of genotypic mutations was different in CSF and plasma, suggesting discordant viral evolution. These results suggest that antiretroviral treatment in children should include agents with activity in the CNS.

Original languageEnglish (US)
Pages (from-to)36-44
Number of pages9
JournalJournal of Pediatrics
Volume141
Issue number1
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    McCoig, C., Castrejón, M. M., Castaño, E., De Suman, O., Báez, C., Redondo, W., McClernon, D., Danehower, S., Lanier, E. R., Richardson, C., Keller, A., Hetherington, S., Sáez-Llorens, X., & Ramilo, O. (2002). Effect of combination antiretroviral therapy on cerebrospinal fluid HIV RNA, HIV resistance, and clinical manifestations of encephalopathy. Journal of Pediatrics, 141(1), 36-44. https://doi.org/10.1067/mpd.2002.125007