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Case Reports
. 2011 Oct;22(10):608-9.
doi: 10.1258/ijsa.2011.010507.

HIV encephalitis despite suppressed viraemia: a case of compartmentalized viral escape

R Bingham  1 , N Ahmed, P Rangi, M Johnson, M Tyrer, J Green
Affiliations
Case Reports

HIV encephalitis despite suppressed viraemia: a case of compartmentalized viral escape

R Bingham et al. Int J STD AIDS. 2011 Oct.

V体育2025版 - Abstract

There is increasing concern that HIV treatment failure may result from inadequate central nervous system (CNS) penetration of antiretroviral drugs, allowing compartmentalized viral replication and development of resistance. We discuss a patient who maintained a suppressed plasma viral load for four years on antiretroviral therapy (ART) before developing HIV encephalitis with a cerebrospinal fluid (CSF) HIV viral load of 861 copies/mL and newly detectable plasma viral load of 68 copies/mL VSports手机版. Identification of major resistance mutations to his combination therapy supported concerns that resistant HIV had developed within the CNS. His ART was changed to optimize CNS penetration, leading to maintained clinical improvement. Imaging presented demonstrates corresponding radiological improvement. The report illustrates the need to exclude CNS viral rebound or incomplete suppression in HIV patients with neurological symptoms, and suggests that the extent of this emerging problem is only beginning to be recognized as the implications of long-term peripheral HIV suppression unfold. .

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