. Author manuscript; available in PMC: 2014 Aug 1.

Published in final edited form as: J Neurovirol. 2013 Jun 5;19(4):402–405. doi: 10.1007/s13365-013-0175-9

Table 1. Clinical and virological evolution over time.

The patient’s laboratory values, cART regimen, HIV dementia scale scores, and HIV genotype are presented, starting with her initial diagnosis of HIV-infection, and subsequent care within the infectious disease and HIV/neurology clinics. Medications marked in bold were those added to the cART regimen based on genotype testing at that time. Didanosine was discontinued at month 54 due to nausea. Only mutations found exclusively in the cerebrospinal fluid and not in the plasma are included. D67N refers to a mutation in which the Aspartic acid (D) normally at amino acid position 67 is substituted by Asparagine (N). N348I refers to a mutation in which Asparagine normally at position 348 is substituted by Isoleucine (I). K20R refers to a mutation in which the Lysine (K) normally at position 20 is substituted by Arginine (R). E399D refers to a mutation in which Glutamic acid (Q) normally at position 399 is substituted by Aspartic acid (E).

	Nadir/HIVdx (month 0)	month 20	month 48	month 54	month 61	months 109–112	months 115–118	months 124–126
CD4 count (cells/uL)	6		769		696	989	559	725
plasma viral load (cps/mL)		272,000	395		undetectable	511	263	75
CSF viral load (cps/mL)			801		294		6950	<20
CSF WBC (cells/uL)			11		5		13	1
CSF protein (mg/dL)			57		56		101	51
cytology			neg		neg		neg
			abacavir³				darunavir/r⁵
			lamivudine⁴	abacavir			raltegravir⁹
	lamivudine	tenofovir	tenofovir²	lamivudine			zidovudine⁷
	zidovudine	didanosine	atazanavir/r¹	tenofovir			lamivudine⁸
			didanosine²				tenofovir⁶
cART regimen	efavirenz	atazanavir/r		atazanavir/r
CPE score (2010)	9	5	10	8			13
HIV dementia scale			11		15	13	12	14.5
Plasma genotype			+				+
CSF genotype			−				+
Unique CSF mutations							+
NRTI							D67N
NNRTI							N348I
PI							K20R
other							E399D

cART= combination antiretroviral therapy; CPE= CNS penetration effectiveness; cps= copies; Dx= diagnosis; neg= negative; NNRTI= non-nucleoside reverse transcriptase inhibitor; NRTI = nucleoside reverse transcriptase inhibitor; PI = protease inhibitor; r= ritonavir boosted;

Susceptibility testing results of the CSF was similar to that in the plasma.

susceptible

low-level resistance

intermediate resistance

⁴

high level resistance

⁵

susceptible

⁶

low-level resistance

⁷

intermediate resistance

⁸

high level resistance

⁹

no resistance profile available