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Drugs and the blood/brain barrier
Nov 30, 2003

Aren't there significant differences in how well the various HIV drugs cross the blood/brain barrier?

I remember reading somewhere that it might be a good idea to select a regimen that included at least one drug that could easily cross this barrier.

What is your expert opinion?

Thank you for your time!

Response from Dr. Pierone

Most of the HIV medications cross the blood-brain barrier to varying degrees and studies have been done to correlate virologic control of HIV in spinal fluid and blood. With standard combination therapy for HIV it is very unusual to see significant evidence of viral replication in the brain when it is controlled in the blood. Even for Kaletra, that in the past was felt to have poor brain penetration, has been shown to have good brain levels as testing methodology has improved. But the answer to you question is yes, at least one medication that crosses blood brain barrier should be part of every regimen.

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