Drugs that penetrate the brain

Treating HIV in the brain can be a challenge, since many antiretroviral drugs cannot cross the blood-brain barrier . Further, studies seem to suggest that the amount of a specific drug that reaches the brain can vary from person to person.

Among the nucleoside reverse transcriptase inhibitors (NRTIs) , AZT (zidovudine, Retrovir), 3TC (lamivudine, Epivir), d4T (stavudine, Zerit) and abacavir (Ziagen) have been shown to penetrate the blood-brain barrier. The nucleotide reverse transcriptase inhibitor tenofovir (Viread) does not enter the central nervous system. The non-nucleoside reverse transcriptase inhibitors (NNRTIs) nevirapine (Viramune) and efavirenz (Sustiva / Stocrin) also reach the central nervous system.

Protease inhibitors penetrate the brain to varying degrees, with amprenavir (Agenerase), fosamprenavir (Telzir), indinavir (Crixivan), atazanavir and lopinavir/ritonavir (Kaletra) reaching the highest levels.1 2 T-20 (enfuvirtide, Fuzeon) does not seem to enter the brain. The ability of the newest anti-HIV drugs to penetrate the blood-brain barrier has not yet been extensively studied in humans.

References

  1. Letendre S et al. Better antiretroviral penetration into the central nervous system is associated with lower CSF viral load. Thirteenth Conference on Retroviruses and Opportunistic Infections, Denver, abstract 74, 2006
  2. Yeh R et al. Single-agent therapy with lopinavir/ritonavir controls HIV-1 viral replication in the central nervous system. Fourteenth Conference on Retroviruses and Opportunistic Infections, Los Angeles, abstract 381, 2007
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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