The New York Times - December 12, 1985
Harold M. Schmeck Jr.

The new findings indicate that the AIDS virus must be added to the list of viruses and bacteria that have long been known to cause meningitis.

Two reports in the current issue of The New England Journal of Medicine strengthen the evidence that HTLV-III, the virus that causes AIDS, or acquired immune deficiency syndrome, can produce infections of the brain and central nervous system, in addition to its well-documented ravages of the body's immune defense system. In some cases the effects on the brain have appeared before there was evidence of destruction of the immune system.

The new evidence "raises the possibility that the central nervous system may serve as a sanctuary for the virus" and that this may complicate the task of developing effective drug treatment against the virus, according to one of the reports.

Barrier Protects Brain

A natural biochemical barrier, the blood-brain barrier, protects the brain from many potentially dangerous things the blood can carry, including many drugs. Because of that a virus that successfully invades the brain might find a sanctuary there.

This could create "a potentially large problem," said Dr. Martin S. Hirsch of Massachusetts General Hospital and Harvard Medical School, one of the leaders of the research.

The report by his group covered 45 patients suffering from AIDS or AIDS-related complex who also suffered from meningitis, dementia or other problems of the brain and central nervous system. The AIDS virus was found in the brain tissues or cerebrospinal fluid of 24 of 33 patients who had AIDS complicated by neurologic symptoms, and in 10 of 16 AIDS patients who suffered from dementia, which involves a loss of memory and other higher mental functions.

The AIDS virus was also found in two patients with AIDS-related complex who had bouts of acute meningitis and in six others who had chronic meningitis. AIDS-related complex involves persistent swollen lymph glands and a decrease in the numbers of a specific type of defense cell, called T-4 cells, that also occurs in AIDS.

Virus May Reproduce in Brain

"On the basis of the above results," the report said, "we believe that HTLV-III must be added to the list of viruses capable of causing aseptic meningitis, particularly in persons at high risk for AIDS." The findings do not suggest that the HTLV-III virus has ever been a cause of meningitis among people outside the known AIDS risk groups, which include male homosexuals and intravenous drug users who share needles.

A related report in the journal offered strong evidence that the AIDS virus grows and reproduces in the brains of AIDS patients, although the specific types of brain cells that are infected are not known.

AIDS was originally defined as a disease that destroys the patient's immune system, but many reports in the past year have also linked the AIDS virus to dementia and damage to the brain and spinal cord.

It has long been known that many AIDS patients suffer such effects as dementia, indicating that the brain has been damaged, but it was originally thought that these effects might result from other infections to which the patients became susceptible because their immune systems were damaged.

AIDS Virus Attacks Brain

Much new evidence suggests instead that the AIDS virus itself attacks the brain. The second report in The New England Journal describes research that demonstrated the presence of antibodies to the AIDS virus inside the blood-brain barrier. The antibodies are believed to reflect virus infection.

The circumstances, said Dr. Robert C. Gallo of the National Cancer Institute, provided strong evidence that the antibodies were produced inside the barrier and did not simply represent "leakage" from the outside.

The report, of which Dr. Gallo was one author, said one patient suffering acute meningitis developed antibodies to the AIDS virus in the course of the acute meningitis attack.

The first of the two related reports on the links between AIDS and brain disease was a collaboration involving scientists at Massachusetts General Hospital and New England Deaconess Hospital in Boston and Mount Sinai Medical Center, Miami Beach.

Evidence of Brain Illness

Involved in the second report were the same three hospitals, the National Cancer Institute at Bethesda, Md., Litton Bionetics Inc. of Kensington, Md., the Veterans Administration Wadsworth Medical Center of Los Angeles and University Hospital in Zurich.

In a recent lecture at Cornell University Medical College here, Dr. Gallo said accumulating evidence shows that the AIDS virus can produce illness involving the brain before there are signs of defects in immunity.

A third report on AIDS in the current New England journal said new research has made it possible to identify those people who have been infected with the HTLV-III virus who are most likely soon to develop full-scale AIDS. The report by scientists at Cornell and Memorial Sloan-Kettering Cancer Center said it is possible to identify those likely to develop AIDS by the presence of swollen lymph glands and mouth infections caused by micro-organisms called candida if such patients' T-cells also respond in certain specific ways to laboratory tests.

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