HIV-1 escape in the central nervous system on elvitegravir-based antiretroviral therapy.
Résumé
Integrase inhibitors are increasingly used in combined antiretroviral therapy (ART) because of their high efficacy in inhibiting HIV replication and favourable tolerance profile. Elvitegravir is used with the pharmacokinetic enhancer cobicistat, associated with tenofovir and emtricitabine in a single-tablet regimen. Very few data are available regarding the diffusion of elvitegravir in the central nervous system (CNS). Herein, we report a case of HIV-associated neurocognitive disorder (HAND) on elvitegravir-based treatment with virological escape in the CNS and the emergence of the elvitegravir-resistance mutation T66I in the cerebrospinal fluid (CSF).