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Recurrent cerebrospinal fluid escape in an HIV-1-infected patient receiving antiretroviral therapy.

Neurological manifestations are occasionally observed in HIV-infected patients receiving effective antiretroviral therapy (ART) with suppressed viraemia and stable immunological state [1]. HIV-1 replication in the central nervous system (CNS) independently of plasma viral load, or cerebrospinal fluid (CSF) escape, is thought to underlie such condition [2]. Such patients have undetectable plasma HIV-1 viral load but have increased viraemia in CSF (0.5 or 1 log greater than plasma) [1].