ArticleThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases2026
Persistent low-level viremia and symptomatic HIV cerebrospinal fluid escape in a person living with HIV receiving darunavir: a case report.
Article in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
HIV Cerebrospinal Fluid (CSF) viral escape is a condition characterized by inadequate virological control within the CSF despite systemic antiretroviral therapy, often assessed through discordant CSF and plasma HIV viral loads. The clinical relevance of CSF viral escape remains poorly understood, but it is thought to contribute to a spectrum of neurological and neurocognitive manifestations. The present study details the case of a 51-year-old individual from São Paulo, Brazil, presenting with acute meningoencephalitis and seizures in the context of persistent low-level viremia. Differential diagnoses were considered to rule out other conditions, such as infectious and immune-related diseases, eventually leading to a diagnosis of HIV CSF viral escape, confirmed through clinical presentation and a series of diagnostic evaluations. Antiretroviral therapy was subsequently optimized to improve central nervous system penetration, resulting in clinical improvement, resolution of neurological symptoms and undetectable CSF viral load.
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