The aim of the present study was to analyse the effect of antiretroviral (ARV) therapy and single antiretroviral drugs on\r\ncerebrospinal fluid (CSF) HIV-RNA burden in HIV-infected patients affected by neurological disorders enrolled in a multicentric\r\nItalian cohort. ARVs were considered ââ?¬Å?neuroactiveââ?¬Â from literature reports. Three hundred sixty-three HIV-positive patients with\r\navailable data from paired plasma and CSF samples, were selected. One hundred twenty patients (33.1%) were taking ARVs at\r\ndiagnosis of neurological disorder. Mean CSF HIV-RNA was significantly higher in naÃ?¨ive than in experienced patients, and in\r\npatients not taking ARV than in those on ARV. A linear correlation between CSF HIV-RNA levels and number of neuroactive\r\ndrugs included in the regimen was also found (r = -0.44, P < 0.001). Low -plasma HIV-RNA and the lack of neurocognitive\r\nimpairment resulted in independently associated to undetectable HIV-RNA. Taking nevirapine or efavirenz, or regimen including\r\nNNRTI, NNRTI plus PI or boosted PI, was independently associated to an increased probability to have undetectable HIV-RNA in\r\nCSF. The inclusion of two or three neuroactive drugs in the ARV regimen was independently associated to undetectable viral load\r\nin CSF. Our data could be helpful in identifying ARV regimens able to better control HIV replication in the CNS sanctuary, and\r\ncould be a historical reference for further analyses.
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