Relationship of cerebrospinal fluid immune activation associated factors to HIV encephalitis.

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Relationship of cerebrospinal fluid immune activation associated factors to HIV encephalitis.

AIDS. 1992 Nov;6(11):1299-307. Unique Identifier : AIDSLINE MED/93112302
Wiley CA; Achim CL; Schrier RD; Heyes MP; McCutchan JA; Grant I; Department of Pathology, University of California San Diego, La; Jolla 92093-0612.

Abstract: OBJECTIVES AND DESIGN: Because macrophages are the predominant immune cell and the predominant infected cell in the brains of patients with HIV encephalitis, we studied macrophage and immune activation-associated factors in the cerebrospinal fluid (CSF) from 39 autopsied AIDS cases for whom complete neuropathologic evaluation of the brain was available. RESULTS: CSF HIV p24 antigen was present in less than one-third of cases (11 out of 39). Less than half of the autopsies with moderate to severe parenchymal infection by HIV had high levels of CSF p24, although all autopsies with elevated levels of HIV p24 had moderate to severe HIV encephalitis. Elevated levels of cytokines, beta 2-microglobulin, neopterin, and quinolinic acid were observed. CONCLUSIONS: Although many of the CSF findings showed a strong correlation with each other, none showed a strong correlation with the severity of HIV infection of the brain itself. The absence of a close association between CSF abnormalities and HIV encephalitis could reflect the abundance of complicating opportunistic infections in these terminally ill patients or the inadequacy of CSF as a marker of basal ganglia involvement in HIV encephalitis. These findings complicate interpretation of clinical studies of CSF in patients with AIDS where neuropathologic evaluation is unavailable.

Keywords: beta 2-Microglobulin/CEREBROSPINAL FLUID Adult AIDS Dementia Complex/*CEREBROSPINAL FLUID/ETIOLOGY/IMMUNOLOGY AIDS-Related Opportunistic Infections/CEREBROSPINAL FLUID/ IMMUNOLOGY Biological Markers/CEREBROSPINAL FLUID Biopterin/ANALOGS & DERIVATIVES/CEREBROSPINAL FLUID Child Cytokines/CEREBROSPINAL FLUID Human HIV Core Protein p24/CEREBROSPINAL FLUID Macrophages/IMMUNOLOGY Middle Age Quinolinic Acid/CEREBROSPINAL FLUID Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE
930430
M9340801

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