HIV p24 antigen (Ag) in the CSF using immune complex dissociation (ICD): correlation with p24 antibodies (Ab) in CSF, CD4, and cerebral atrophy.

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

HIV p24 antigen (Ag) in the CSF using immune complex dissociation (ICD): correlation with p24 antibodies (Ab) in CSF, CD4, and cerebral atrophy.

Abstr Gen Meet Am Soc Microbiol. 1994;94:622 (abstract no. V-30). Unique Identifier : AIDSLINE ASM94/94313120
Valdez LM; Donovan RM; Mateo NB; Manzor O; Baxa D; Markowitz NP; Saravolatz LD; Department of Infectious Diseases, Henry Ford Hospital, Detroit,; Michigan.

Abstract: The central nervous system is a major target for HIV infection. Studies have suggested that p24 Ag in the CSF is associated with the AIDS Dementia Complex (ADC). We studied 22 HIV infected patients for the presence of p24 Ag and correlated these findings with the presence of p24 Ab, cerebral atrophy by CT or MRI, and CD4 count. HIV p24 Ag was measured in plasma and CSF with and without ICD (Coulter). CSF p24 Ab was determined using western blot (Dupont). ICD detected 5 patients with positive p24Ag (22.7%) but only 3 of these patients (13.6%) were detected by the free method. Cerebral atrophy was demonstrated in all 5 patients with CSF p24 Ag, but in only 2 of 17 patients who were CSF p24 Ag negative (p < 0.001). Western blot detected CSF p24 Ab in 9 individuals. All the patients with p24 Ab, were p24 Ag negative in their CSF (p = 0.056). Only 1 of these 9 showed evidence of cerebral atrophy. Neither the presence or the magnitude of plasma p24 Ag (with or without ICD) correlated with CSF findings or cerebral atrophy. The mean CD4 in patients who had positive CSF p24 Ag was 9 +/- 6.2 cells/microliters, compared to 103.9 +/- 165.09 cells/microliters in the patients with a negative Ag. In conclusion: 1) ICD increases the sensitivity of p24 Ag detection in the CSF. 2) The presence of HIV p24 Ag in the CSF (free or ICD) was associated with cerebral atrophy; 71% of those with cerebral atrophy had detectable p24 Ag in their CSF. Therefore CSF ICD p24 Ag may be of value in the diagnosis of ADC.

Keywords: Age Factors *Antigen-Antibody Complex Atrophy AIDS Dementia Complex/*CEREBROSPINAL FLUID/*DIAGNOSIS/PATHOLOGY Brain/*PATHOLOGY Comparative Study CD4-Positive T-Lymphocytes/*MICROBIOLOGY Human HIV Antibodies/*ANALYSIS/BLOOD/*CEREBROSPINAL FLUID HIV Core Protein p24/*CEREBROSPINAL FLUID/IMMUNOLOGY HIV Infections/*CEREBROSPINAL FLUID/PATHOLOGY Sensitivity and Specificity ABSTRACT
941030
M94A0834

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