Dolutegravir Cerebrospinal Fluid Diffusion in HIV-1-Infected Patients with Central Nervous System Impairment

Thibaut Gelé; Valérie Furlan; Anne-Marie Taburet; Coralie Pallier; Pierre-Hadrien Becker; Cécile Goujard; Jacques Gasnault; Aurélie Barrail-Tran; Antoine Chéret

doi:10.1093/ofid/ofz174

Dolutegravir Cerebrospinal Fluid Diffusion in HIV-1-Infected Patients with Central Nervous System Impairment

Open Forum Infect Dis. 2019 Jun 3;6(6):ofz174. doi: 10.1093/ofid/ofz174. eCollection 2019 Jun.

Authors

Thibaut Gelé^{1

2}, Valérie Furlan³, Anne-Marie Taburet², Coralie Pallier⁴, Pierre-Hadrien Becker⁵, Cécile Goujard^{6

7

8}, Jacques Gasnault^{2

6}, Aurélie Barrail-Tran^{1

2

9}, Antoine Chéret^{6

10}

Affiliations

¹ Department of Clinical Pharmacy, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
² CEA-Paris-Sud University-INSERM U1184, IDMIT Infrastructure, Fontenay-aux-Roses, France.
³ Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
⁴ Department of Virology, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Paul-Brousse, Villejuif, France.
⁵ Department of Biochemistry, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
⁶ Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
⁷ CESP, Paris-Sud University-INSERM U1018, Villejuif, France.
⁸ College of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France.
⁹ College of Pharmacy, Paris-Sud University, Châtenay-Malabry, France.
¹⁰ Paris-Descartes University-INSERM U1016, CNRS 8104, Institut Cochin, Paris, France.

Abstract

This study aimed to determine dolutegravir cerebrospinal fluid (CSF) diffusion in 13 patients with HIV-related cerebral impairment enrolled in a real-life observational study. Dolutegravir median (range) CSF concentration [9.6 (3.6-22.8) ng/mL] reached CSF therapeutic concentrations whatever the blood-brain barrier status and diffused in correlation with the albumin quotient (P = .0186).

Keywords: central nervous system diffusion; central nervous system impairment; cerebrospinal fluid; dolutegravir; pharmacokinetics.