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do my meds enter the brain
Jun 30, 2008

Hi Dr. McGownan, I am taking the following meds;prezista,issentriss,intellence,truvada and norvir-I have cogitive deficits-do any of my medications penetrate the brain-my VL<50, T-cells 504. Thankyou

Response from Dr. McGowan

The relationship between penetration of HIV drugs into the central nervous system (including the brain) and risk of either developing central nervous system disease or reversing existing cognitive deficits has not been clearly and definitively established. Your medication regimen is one usually prescribed to someone who is treatment experienced. I am very glad that your viral load is < 50 and your CD4 count is above 500. I would not alter your current regimen and, for example, substitute your prezista with indinavir because indinivar achieves better central nervous system penetration than prezista. In other words, achieving better CNS penetration of a drug your virus may have developed resistance to is not a strategy that I would advocate. The most important goal is to select a regimen that is going to achieve durable viral suppression. If one is fully susceptible to drug A and drug B and drug A has better CNS penetration compared with drug B, I might consider drug A over drug B all other things being equal.

Joe


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