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Drugs that cross blood/brain barrier
Sep 1, 2002

Is there information regarding the effectiveness of the HIV drugs to successfully cross the blood/brain barrier. I have read that some drugs do not while others are more effective. Can the virus be gone from the blood yet still be very active in the brain? Which drugs do you recommend?

Response from Dr. Henry

The NNRTI class (esp nevirapine and efavirenz) cross the blood brain barrier well. There is good experience with AZT crossing the blood brain barrier and some with 3TC. The other NRTIs have been less well studied. Of the PIs, indinavir with its low protein binding has demonstrated reasonably CSF levels. It is possible to have cleared the virus from the plasma abut not the CSF but ordinarily the two compartments do mirror each other (with some exceptions well documented). KH



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