{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:08:33Z","timestamp":1779275313216,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Higher risk of cerebrospinal fluid escape (CVE) has been associated with the use of specific antiretroviral (ARV) classes, such as protease inhibitors. We assessed whether archived resistance\u2010associated mutations (RAMs) can mediate this relationship by identifying patients treated with incompletely active antiretroviral regimens. A retrospective multicentric study on 282 adult people with HIV on antiretroviral therapy (ART) and available historical plasma genotype resistance testing (HGRT) for reverse transcriptase (RT) and protease genes between 2001 and 2021. The odds ratio for demographic, clinic\u2010, and ART\u2010related variables and CVE was estimated by multivariable modeling. HGRT\u2010adjusted central nervous system effectiveness penetration (CPE) score was computed in modeling the risk. Median age, plasma VL, and CD4 count were 49 years, &lt;50\u2009copies\/mL, and 310\u2009cells\/\u03bcL. CVE was detected in 51 participants (17.0%). No difference in CVE prevalence was observed according to ART type, number of ARVs or ARV classes. Participants with CVE had more frequently plasma (52.9% vs. 32.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) and CSF RAMs in RT (<jats:italic>n<\/jats:italic>\u2009=\u200963, 57.1% vs. 28.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.029), but not in protease gene. The presence of plasma RAMs in RT associated with increased odds of CVE in adjusted analyses (aOR 3.9, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and in models restricted to plasma viral load \u226450 copies\/mL (<jats:italic>n<\/jats:italic>\u2009=\u2009202; aOR 4.3, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). CVE risk decreased by 40% per each point increase in HGRT\u2010adjusted CPE score in multivariable models (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Rather than the type of ARV classes or of ART regimens, functional mono or dual regimens caused by the presence of RAMs affecting ART components may explain the majority of cases of CVE.<\/jats:p>","DOI":"10.1002\/jmv.28704","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T04:54:31Z","timestamp":1679892871000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The presence of resistance\u2010associated mutations in reverse transcriptase gene is associated with cerebrospinal fluid HIV\u20101 escape: A multicentric retrospective analysis"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8663-719X","authenticated-orcid":false,"given":"Mattia","family":"Trunfio","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin 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