Switching from a regimen containing abacavir/lamivudine or emtricitabine/tenofovir disoproxil fumarate to emtricitabine/tenofovir alafenamide fumarate does not affect central nervous system HIV-1 infection
Artikel i vetenskaplig tidskrift, 2019

Background: Despite suppressive antiretroviral therapy (ART), many HIV-infected individuals have low-level persistent immune activation in the central nervous system (CNS). There have been concerns regarding the CNS efficacy of tenofovir alafenamide fumarate (TAF) because of its low cerebrospinal fluid (CSF) concentrations and because it is a substrate of the active efflux transporter P-glycoprotein. Our aim was to investigate whether switching from emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) or abacavir (ABC)/lamivudine (3TC) to FTC/TAF would lead to changes in residual intrathecal immune activation, viral load, or neurocognitive function.

Methods: Twenty HIV-1-infected neuro-asymptomatic adults (11 on ABC/3TC and 9 on FTC/TDF) were included in this prospective study. At baseline, all participants changed their nucleoside analogues to FTC/TAF without any other changes in their ART regimen. We performed lumbar punctures, venipunctures, and neurocognitive testing at baseline and after three and 12 months.

Results: During follow-up, there were no significant changes in CSF or plasma HIV RNA, CSF neopterin, CSF β2-microglobulin, IgG index, albumin ratio, CSF NFL, or neurocognitive function in assessed by Cogstate in any of the groups.

Conclusion: This small pilot study indicates that switching to FTC/TAF from ABC/3TC or FTC/TDF has neither a positive, nor a negative effect on the HIV infection in the CNS.

NFL

neopterin

tenofovir alafenamide fumarate

cerebrospinal fluid

central nervous system

HIV-1

Författare

Aylin Yilmaz

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Åsa Mellgren

Södra Älvsborg Hospital

D. Fuchs

Medizinische Universität Innsbruck

Staffan Nilsson

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Kaj Blennow

Sahlgrenska universitetssjukhuset

Göteborgs universitet

Henrik Zetterberg

Sahlgrenska universitetssjukhuset

University College London (UCL)

Göteborgs universitet

UCL Institute of Neurology

Magnus Gisslen

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Infectious Diseases

2374-4235 (ISSN) 2374-4243 (eISSN)

Vol. 51 11-12 838-846

Ämneskategorier

Sjukgymnastik

Infektionsmedicin

Neurologi

DOI

10.1080/23744235.2019.1670352

PubMed

31556765

Mer information

Senast uppdaterat

2019-11-11