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CNS Drugs
Published in: CNS Drugs 1/2013

01-01-2013 | Review Article

CSF Penetration by Antiretroviral Drugs

Authors: Christine Eisfeld, Doris Reichelt, Stefan Evers, Ingo Husstedt

Published in: CNS Drugs | Issue 1/2013

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Abstract

Severe HIV-associated neurocognitive disorders (HAND), such as HIV-associated dementia, and opportunistic CNS infections are now rare complications of HIV infection due to comprehensive highly active antiretroviral therapy (HAART). By contrast, mild to moderate neurocognitive disorders remain prevalent, despite good viral control in peripheral compartments. HIV infection seems to provoke chronic CNS injury that may evade systemic HAART. Penetration of antiretroviral drugs across the blood–brain barrier might be crucial for the treatment of HAND. This review identifies and evaluates the available clinical evidence on CSF penetration properties of antiretroviral drugs, addressing methodological issues and discussing the clinical relevance of drug concentration assessment. Although a substantial number of studies examined CSF concentrations of antiretroviral drugs, there is a need for adequate, well designed trials to provide more valid drug distribution profiles. Neuropsychological benefits and neurotoxicity of potentially CNS-active drugs require further investigation before penetration characteristics will regularly influence therapeutic strategies and outcome.
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Metadata
Title
CSF Penetration by Antiretroviral Drugs
Authors
Christine Eisfeld
Doris Reichelt
Stefan Evers
Ingo Husstedt
Publication date
01-01-2013
Publisher
Springer International Publishing AG
Published in
CNS Drugs / Issue 1/2013
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.1007/s40263-012-0018-x

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