Virological Response in Cerebrospinal Fluid to Antiretroviral Therapy in a Large Italian Cohort of HIV-Infected Patients with Neurological Disorders
Table 2
Factors related to undetectable HIV-RNA levels in cerebrospinal fluid (CSF) at logistic regression model adjusted for age, gender, HIV-transmission route, time on HAART before neurological diagnosis (more or less than 6 months), abnormal mental status, cerebral atrophy, and neurological disorder.
Variables
Crude OR (95% CI)
-value
Model 1
Model 2
Model 3
Adjusted OR (95% CI)
-value
Adjusted OR (95% CI)
-value
Adjusted OR (95% CI)
-value
Plasma HIV-RNA (log10 cp/mL)
0.57 (0.47–0.69)
<0.01
0.70 (0.51–0.95)
0.024
0.70 (0.51–0.96)
0.027
0.68 (0.51–0.91)
0.009
CD4 at diagnosis
1.05 (0.97–1.14)
0.221
0.97 (0.86–1.10)
0.680
0.96 (0.85–1.09)
0.557
0.96 (0.86–1.08)
0.473
(50 cells increase)
Drugs at diagnosis
(i) AZT
3.60 (1.83–7.08)
<0.01
2.15 (0.51–9.04)
0.295
(ii) DDI
2.37 (0.93–6.04)
0.071
1.67 (0.37–7.65)
0.508
(iii) D4T
3.65 (1.95–6.83)
<0.01
1.53 (0.41–5.65)
0.527
(iv) 3TC
4.53 (2.54–8.10)
<0.01
1.62 (0.39–6.66)
0.505
(v) ABV
1.17 (0.32–4.25)
0.807
0.22 (0.03–1.68)
0.144
(vi) NVP
4.10 (1.37–12.28)
0.012
4.46 (1.03–19.32)
0.045
(vii) EFV
7.38 (3.21–16.95)
<0.01
4.87 (1.16–20.54)
0.031
(viii) IDV
1.90 (0.58–6.17)
0.288
0.86 (0.16–4.50)
0.856
(ix) IDV/r
3.14 (0.73–14.49)
0.125
2.06 (0.31–13.58)
0.454
(x) NFV
1.66 (0.63–4.35)
0.302
0.68 (0.16–2.78)
0.587
(xi) LPV/r
2.21 (0.75–6.51)
0.152
1.10 (0.22–5.64)
0.907
Drug classes
(i) No ARV
1.00
1.00
(ii) NNRTIs-based regimens
14.32 (6.13–33.44)
<0.01
12.46 (3.28–47.4)
<0.001
(iii) PIs-based regimens
3.50 (1.54–7.96)
<0.01
2.48 (0.75–8.22)
0.138
(iv) Boosted PIs-based regimens
6.88 (2.42–19.52)
<0.01
5.64 (1.31–24.25)
0.020
(v) Only NRTIs
3.22 (0.83–12.53)
0.092
1.25 (0.09–17.10)
0.866
(vi) PI + NNRTIs-based regimens
7.07 (1.57–31.89)
0.01
10.42 (1.59–68.46)
0.015
Number of neuroactive drugs
(i) 0
1.00
1.00
(ii) 1
1.68 (0.20–14.41)
0.634
1.67 (0.16–17.82)
0.673
(iii) 2
6.50 (3.01–14.04)
<0.01
4.11 (1.22–13.79)
0.022
(iv) 3-4
6.58 (3.32–13.05)
<0.01
5.48 (1.94–15.48)
0.001
Cognitive symptoms
0.47 (0.27–0.83)
<0.01
0.38 (0.16–0.90)
0.029
0.38 (0.16–0.88)
0.025
0.41 (0.18–0.95)
0.038
OR: odds ratio; IVDU: intravenous drug users; MSM: men who have sex with men; AZT: zidovudine; DDI: didanosine; D4T: stavudine; 3TC: lamivudine; ABV: abacavir; NVP: nevirapine; EFV: efavirenz; IDV/r: indinavir/ritonavir; IDV: indinavir; NFV: nelfinavir; LPV/r: lopinavir/ritonavir; ARV: antiretroviral therapy; NNRTI: nonnucleoside reverse trascriptase inhibitors; PI: protease inhibitors; NRTI: nucleoside reverse trascriptase inhibitors; HAART: highly active antiretroviral therapy; HIVE: HIV encephalopathy; PML: progressive multifocal leucoencephalopathy; EUO: encephalopathies of unknown origin; TE: toxoplasmic encephalitis; PCNSL: primary central nervous system cerebral lymphoma; CM: cryptococcosis; TB: CNS tuberculosis/tubercular meningitis.
