Viral Escape in the Central Nervous System with Multidrug-Resistant Human Immunodeficiency Virus-1

C Béguelin; M Vázquez; M Bertschi; S Yerly; D de Jong; K Gutbrod; A Rauch; A Cusini

doi:10.1093/ofid/ofv210

Viral Escape in the Central Nervous System with Multidrug-Resistant Human Immunodeficiency Virus-1

Open Forum Infect Dis. 2015 Dec 28;3(1):ofv210. doi: 10.1093/ofid/ofv210. eCollection 2016 Jan.

Authors

C Béguelin¹, M Vázquez¹, M Bertschi², S Yerly³, D de Jong², K Gutbrod², A Rauch¹, A Cusini⁴

Affiliations

¹ Department of Infectious Diseases , Inselspital, Bern University Hospital, University of Bern.
² Department of Neurology , Bern University Hospital and University of Bern.
³ Laboratory of Virology , Geneva University Hospital.
⁴ Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern; Infectious Diseases Unit, Cantonal Hospital, Chur, Switzerland.

Abstract

In this study, we report the case of a patient infected with human immunodeficiency virus (HIV)-1 who developed ataxia and neurocognitive impairment due to viral escape within the central nervous system (CNS) with a multidrug-resistant HIV-1 despite long-term viral suppression in plasma. Antiretroviral therapy optimization with drugs with high CNS penetration led to viral suppression in the CSF, regression of ataxia, and improvement of neurocognitive symptoms.

Keywords: HIV; K65R; central nervous system; multidrug-resistant; viral escape.