Presence of mutation conferring resistance to lamivudine in plasma and cerebrospinal fluid of HIV-1-infected patients

To explore the relation between levels of HIV-1 in the cerebrospinal fluid (CSF) and plasma, simultaneously obtained samples from twelve patients who were receiving or had received lamivudine were examined; HIV-1 RNA levels were measured by nucleic acid sequence-based amplification procedure (NASBA). HIV-1 pol gene was amplified and sequenced. Median plasma and CSF HIV-1 RNA levels were 4.98 log and 2.93 log respectively. In total, 5 patients had CSF levels <100 copies/ml. A significant correlation between plasma and CSF HIV-1 RNA levels was found; 3 patients with disproportionately elevated CSF HIV-l RNA levels had clinical evidence of central nervous system disease. Genotypic analysis was available for 9 plasma/CSF pairs. In 4, the lamivudine (3TC)-resistance mutation M184V was found in both CSF and plasma. Discordance was found in 2 pairs. In both, M184V was found in plasma but not CSF. These data suggest that CSF and plasma levels of HIV-1 may be correlated.