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efavirenz and other CNS penetrating drugs
Oct 25, 2012

dear doc, in atripla, only the efavirenz can cross blood brain barrier. so, in the CNS environment, we are effectively applying monotherapy with efavirenz which theoretically should raise efavirenz resistance in the CNS HIV load. then how atripla works for so many years for one individual? regards.

Response from Dr. Young

Hi and thanks for posting.

Your's is a very interesting question- one of intense research. The key part of the answer is that efavirenz does cross into the brain and spinal fluid, just less than other medications. The pragmatic answer is that it must reach this area well enough for most cases, but obviously there's much more to learn (including a recent report about possible toxicity of an efavirenz metabolite).

I've written about this subject (with references) in a recent posting on this Forum.

Be well, BY



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