Integrase inhibitor-resistant HIV-1 was detected in the cerebrospinal fluid, but not in the plasma of a 42-year-old man with HIV encephalopathy treated with a raltegravir (RAL)-containing regimen. Raltegravir resistance may develop in the central nervous system when the virus is already multi-drug resistant because of different penetration into cerebrospinal fluid of individual antiretroviral agents.
SteigbigelRT, CooperDA, KumarPN, Raltegravir with optimized background therapy for resistant HIV-1 infection. N Engl J Med2008;359:339–54
2.
LennoxJ, DeJesusE, LazzarinA, STARTMRK, a phase III study of the safety & efficacy of raltegravir (RAL)-based vs efavirenz (EFV)-based combination therapy in treatment-naïve HIV-infected patients [abstract H-896a]. In: Program and Abstracts of the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy (Washington, DC). Washington, DC: American Society for Microbiology, 2008
3.
CooperDA, SteigbigelRT, GatellJM, Subgroup and resistance analyses of raltegravir for resistant HIV-1 infection. N Engl J Med2008;359:355–65
4.
JohnsonVA, Brun-VezinetF, ClotetB, Update of the drug resistance mutations in HIV-1. Top HIV Med2008;16:138–45
5.
CalcagnoA, BanoraS, BertucciR, Raltegravir penetration in the cerebrospinal fluid of HIV-positive patients. AIDS2010;24:931–32
6.
IwamotoM, WenningLA, PetryAS, Safety, tolerability, and pharmacokinetics of raltegravir after single and multiple doses in healthy subjects. Clin Pharmacol Ther2008;83:293–9
7.
AntinoriA, PernoCF, GiancolaML, Efficacy of cerebrospinal fluid (CSF) — penetrating antiretroviral drugs against HIV in the neurological compartment: different patterns of phenotypic resistance in CSF and plasma. Clin Infect Dis2005;41:1787–93
