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Author Topic: Isentress - Central Nervous System Penetration  (Read 4459 times)

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Offline freestate guy

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Isentress - Central Nervous System Penetration
« on: July 13, 2009, 11:17:11 pm »
I have been on Isentress since December, 2007, and have been pleased with the results and lack of side effects so far. I have recommended it to others and would continue to do so. And, I was pleased to see its FDA approval as a first line treatment.

At my last visit with my very knowledgeable ID doc, I asked about the drug's ability to penetrate the central nervous system and was told that it is "average". While I am not sure of the significance of the characterization, it is not what I was hoping to hear given that over the last few years (preceding taking Isentress), I have felt some cognitive slipping. Not sure whether its normal aging, years of medication, the virus, or something totally unrelated. I hope to get that condition evaluated to see how serious it really is.

I then read about the very recent AIDS Clinical Trials Study (AIDSmeds - July 1) which concluded that the tested antiretrovirals (I don't think that Isentress was tested) which do penetrate the CNS may not actually protect the brain from cognitive impairment even though HIV in the brain may be reduced. Indeed, cognitive impairment seemed to be worse for those taking ARVs with high CNS penetration. While other small studies apparently have concluded differently, this study makes the whole issue of CNS penetration (or lack of it) in one's treatment difficult to gage.

Clearly, a lot more study is needed but I'm not sure what to make of this. Any thoughts?

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Offline Inchlingblue

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Re: Isentress - Central Nervous System Penetration
« Reply #1 on: July 14, 2009, 01:31:42 am »
I also have read those studies you mention and it is confusing. The one thing I think was a consensus was that earlier treatment lead to less cognitive decline.

I guess it's probably good to take the supplements that are known to be good for the brain and do not interfere with the meds, such as the Omega oils.
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Offline AndyArrow

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Re: Isentress - Central Nervous System Penetration
« Reply #2 on: July 14, 2009, 08:58:05 am »
You might find this study presented at the 16th CROI in Montreal helpful. 

The length of infection & a persons CD4 count before starting HAART are also factors.

http://www.natap.org/2009/CROI/croi_111.htm

Also simply exercising the brain on a regular basis (ie reading a book or doing crossword puzzles) is believe to help limit the possible impact.
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