Q: What is CNS viral escape syndrome?
Answer: CNS viral escape syndrome is an HIV related phenomenon in which despite compliant treatment with antiretroviral therapy (ART), patients develop neurological deficits popularly known as HAND (HIV-associated neurocognitive disorders). Although viral load stays low in the plasma there is evidence of CNS HIV replication in the cerebrospinal fluid (CSF). This is due to drug resistance to the virus in the CSF.
HAND is mostly characterized by difficulty with attention, lagging of memory, lack of cerebrating decisions and slowing down of cognitive and motor skills.
1. Peluso MJ, Ferretti F, Peterson J, et al. Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. AIDS 2012; 26:1765.
2. Canestri A, Lescure FX, Jaureguiberry S, et al. Discordance between cerebral spinal fluid and plasma HIV replication in patients with neurological symptoms who are receiving suppressive antiretroviral therapy. Clin Infect Dis 2010; 50:773.