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Adaptation of antiretroviral therapy in human immunodeficiency virus infection with central nervous system involvement

Mehling, Matthias ; Drechsler, Henning ; Kuhle, Jens ; Hardmeier, Martin ; Doerries, Ruediger ; Ruegg, Stephan ; Gass, Achim

In: Journal of NeuroVirology, 2008, vol. 14, no. 1, p. 78-84

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    Titre
    • Adaptation of antiretroviral therapy in human immunodeficiency virus infection with central nervous system involvement
    Auteur
    • Mehling, Matthias. Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
    • Drechsler, Henning. Department of Internal Medicine, University Hospital of Basel, Switzerland
    • Kuhle, Jens. Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
    • Hardmeier, Martin. Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
    • Doerries, Ruediger. Department of Virology, University Hospital of Mannheim, Germany
    • Ruegg, Stephan. Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
    • Gass, Achim. Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:314662
    Summary
    The authors describe a patient with known human immunodeficiency virus (HIV)-1 infection who presented with two generalized seizures and was found to have extensive white matter disease and a left/bilateral temporo-occipital focal slowing on electroencephalography (EEG). There were no magnetic resonance imaging (MRI) or cerebrospinal fluid (CSF) indications for opportunistic infection. Plasma viremia was controlled, whereas viral replication was uncontrolled in CSF. CSF-specific genotype-guided adaptation of the antiretroviral therapy in order to optimize central nervous system (CNS) penetration resulted in clinical improvement and normalization of MRI and EEG. Our case report illustrates the importance of individualized antiretroviral therapy in HIV infected patients with neurological complications