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Cerebrospinal Fluid and Human Immunodeficiency Virus: Findings in Healthy, Asymptomatic, Seropositive Men

Cerebrospinal Fluid and Human Immunodeficiency Virus: Findings in Healthy, Asymptomatic,... Abstract • Involvement of the central nervous system by human immunodeficiency virus is an important cause of morbidity and mortality. We have undertaken a longitudinal study of asymptomatic individuals found to be human immunodeficiency virus seropositive to identify and characterize cerebrospinal fluid abnormalities early in the disease process. Our findings in 25 individuals have been notable for a frequent incidence of cerebrospinal fluid abnormalities. Pleocytosis or elevated cerebrospinal fluid protein was found in 12 (48%) of 15 patients studied. Oligoclonal banding was present in 6 (26%) of 23 patients. Human immunodeficiency virus was isolated by culture in 4 asymptomatic patients. The cerebrospinal fluid abnormalities we observed indicate an active process occurring in the central nervous system, even in early human immunodeficiency virus infection in asymptomatic patients. Serial observation of these patients for development of neuropsychiatric findings may provide answers to the significance of cerebrospinal fluid abnormalities identified in these patients. (Arch Intern Med. 1990;150:1538-1540) References 1. Price RW, Brew B, Sidtis J, Rosenblum M, Schneck AC, Cleary P. The brain in AIDS central nervous system HIV infection and AIDS dementia complex . Science . 1988;239:586-592.Crossref 2. Gabuzda DH, Ho DD, de la Monte SM, Hirsh MS, Rota TR, Sobel RA. Immunohistochemical identification of HTLV-III antigen in brains of patients with AIDS . Ann Neurol . 1986;20:289-295.Crossref 3. Shaw GM, Epstein LG, Price RW, et al. HTLV-III infection in brains of children and adults with AIDS encephalopathy . Science . 1985;227:177-181.Crossref 4. Ho DD, Rota TR, Schooley RT, et al. Isolation of HTLV-III from cerebrospinal fluid and neural tissue of patients with neurological syndromes related to acquired immunodeficiency syndrome . N Engl J Med . 1985;313:1493-1497.Crossref 5. Levy JA, Shimabukuro J, Hollander H, Mills J, Kaminsky L. Isolation of AIDS associated retrovirus from cerebrospinal fluid and brains of patients with neurological symptoms . Lancet . 1985;2:586-588. 6. Navia BA, Jordan BD, Price RW. The AIDS dementia complex, I: clinical features . Ann Neurol . 1986;19:517-524.Crossref 7. Navia BA, Cho ES, Petito CK, et al. The AIDS dementia complex, II: neuropathology . Ann Neurol . 1986;19:525-535.Crossref 8. De la Monte SM, Ho DD, Schooley RT, Hirsh MS, Richardson EP Jr. Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection . Neurology . 1987;37:562-569.Crossref 9. Navia BA, Price RW. The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection . Arch Neurol . 1987;44:65-69.Crossref 10. Letter from the Assistant Secretary of Defense for Health Affairs. Policy on Standardized Evaluation, Staging and Disease Coding of Military Personnel Infected with Human T-Lymphotropic Virus Type III (HTLV-III) . Washington, DC; (March 12) , 1986. 11. Janssen RS, Saykin AJ, Kaplan JE, et al. Neurological complications of human immunodeficiency virus infection in patients with lymphadenopathy syndrome . Ann Neurol . 1988;23:49-55.Crossref 12. Hollander H, Levy JA. Neurological abnormalities and recovery of human immunodeficiency virus from cerebrospinal fluid . Ann Intern Med . 1987;107:692-695.Crossref 13. McArthur JC, Cohen BA, Farzedegan H. Cerebrospinal fluid abnormalities in homosexual men with and without neuropsychiatric findings . Ann Neurol . 1988;23( (suppl) ):34-37.Crossref 14. Janssen RS, Saykin AJ, Kaplan JE, et al. Neurological symptoms and neuropsychological abnormalities in lymphadenopathy syndrome . Ann Neurol . 1988;23( (suppl) ):17-18.Crossref 15. Rubinow DR, Barrettini CH, Brouwers P, Clifford Lane H. Neuropsychiatric consequence of AIDS . Ann Neurol . 1988;23( (suppl) ):24-26.Crossref 16. Marshall DW, Brey RL, Cahill WT, Houk RW, Zajac RA, Boswell RN. Spectrum of cerebrospinal fluid findings in various stages of human immunodeficiency virus infection . Arch Neurol . 1988;45:954-958.Crossref 17. Cheng-Mayer C, Levy JA. Distinct biological and serological properties of human immunodeficiency virus from the brain . Ann Neurol . 1988; 23( (suppl) ):58-61.Crossref 18. Anand R. Natural variants of human immunodeficiency virus from patients with neurological disorders do not kill T4+ cells . Ann Neurol . 1988;23( (suppl) ):66-70.Crossref 19. Resnick L, Berger JR, Shapshak P, Tourtellotte WW. Early penetration of the blood-brain-barrier by HIV . Neurology . 1988;38:9-14.Crossref 20. Farrell MA, Kaufmann JCE, Gilbert JJ, Noseworthy JH, Armstrong HA, Ebers GC. Oligoclonal bands in multiple sclerosis: clinical pathological correlation . Neurology . 1985;35:212-218.Crossref 21. Weber JN, Weiss RA, Roberts C. Human immunodeficiency virus infection in two cohorts of homosexual men: neutralizing sera and association of antigag antibody with prognosis . Lancet . 1987;1:119-122.Crossref 22. Lange J, Goudsmit J. Decline of antibody reactivity to HIV core protein secondary to increased production of HIV antigen . Lancet . 1987;1:448.Crossref 23. Epstein LG, Goudsmit J, Paul DA, et al. Expression of human immunodeficiency virus in cerebrospinal fluid of children with progressive encephalopathy . Ann Neurol . 1987;21:397-401.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cerebrospinal Fluid and Human Immunodeficiency Virus: Findings in Healthy, Asymptomatic, Seropositive Men

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1990.00390190170030
Publisher site
See Article on Publisher Site

Abstract

Abstract • Involvement of the central nervous system by human immunodeficiency virus is an important cause of morbidity and mortality. We have undertaken a longitudinal study of asymptomatic individuals found to be human immunodeficiency virus seropositive to identify and characterize cerebrospinal fluid abnormalities early in the disease process. Our findings in 25 individuals have been notable for a frequent incidence of cerebrospinal fluid abnormalities. Pleocytosis or elevated cerebrospinal fluid protein was found in 12 (48%) of 15 patients studied. Oligoclonal banding was present in 6 (26%) of 23 patients. Human immunodeficiency virus was isolated by culture in 4 asymptomatic patients. The cerebrospinal fluid abnormalities we observed indicate an active process occurring in the central nervous system, even in early human immunodeficiency virus infection in asymptomatic patients. Serial observation of these patients for development of neuropsychiatric findings may provide answers to the significance of cerebrospinal fluid abnormalities identified in these patients. (Arch Intern Med. 1990;150:1538-1540) References 1. Price RW, Brew B, Sidtis J, Rosenblum M, Schneck AC, Cleary P. The brain in AIDS central nervous system HIV infection and AIDS dementia complex . Science . 1988;239:586-592.Crossref 2. Gabuzda DH, Ho DD, de la Monte SM, Hirsh MS, Rota TR, Sobel RA. Immunohistochemical identification of HTLV-III antigen in brains of patients with AIDS . Ann Neurol . 1986;20:289-295.Crossref 3. Shaw GM, Epstein LG, Price RW, et al. HTLV-III infection in brains of children and adults with AIDS encephalopathy . Science . 1985;227:177-181.Crossref 4. Ho DD, Rota TR, Schooley RT, et al. Isolation of HTLV-III from cerebrospinal fluid and neural tissue of patients with neurological syndromes related to acquired immunodeficiency syndrome . N Engl J Med . 1985;313:1493-1497.Crossref 5. Levy JA, Shimabukuro J, Hollander H, Mills J, Kaminsky L. Isolation of AIDS associated retrovirus from cerebrospinal fluid and brains of patients with neurological symptoms . Lancet . 1985;2:586-588. 6. Navia BA, Jordan BD, Price RW. The AIDS dementia complex, I: clinical features . Ann Neurol . 1986;19:517-524.Crossref 7. Navia BA, Cho ES, Petito CK, et al. The AIDS dementia complex, II: neuropathology . Ann Neurol . 1986;19:525-535.Crossref 8. De la Monte SM, Ho DD, Schooley RT, Hirsh MS, Richardson EP Jr. Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection . Neurology . 1987;37:562-569.Crossref 9. Navia BA, Price RW. The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection . Arch Neurol . 1987;44:65-69.Crossref 10. Letter from the Assistant Secretary of Defense for Health Affairs. Policy on Standardized Evaluation, Staging and Disease Coding of Military Personnel Infected with Human T-Lymphotropic Virus Type III (HTLV-III) . Washington, DC; (March 12) , 1986. 11. Janssen RS, Saykin AJ, Kaplan JE, et al. Neurological complications of human immunodeficiency virus infection in patients with lymphadenopathy syndrome . Ann Neurol . 1988;23:49-55.Crossref 12. Hollander H, Levy JA. Neurological abnormalities and recovery of human immunodeficiency virus from cerebrospinal fluid . Ann Intern Med . 1987;107:692-695.Crossref 13. McArthur JC, Cohen BA, Farzedegan H. Cerebrospinal fluid abnormalities in homosexual men with and without neuropsychiatric findings . Ann Neurol . 1988;23( (suppl) ):34-37.Crossref 14. Janssen RS, Saykin AJ, Kaplan JE, et al. Neurological symptoms and neuropsychological abnormalities in lymphadenopathy syndrome . Ann Neurol . 1988;23( (suppl) ):17-18.Crossref 15. Rubinow DR, Barrettini CH, Brouwers P, Clifford Lane H. Neuropsychiatric consequence of AIDS . Ann Neurol . 1988;23( (suppl) ):24-26.Crossref 16. Marshall DW, Brey RL, Cahill WT, Houk RW, Zajac RA, Boswell RN. Spectrum of cerebrospinal fluid findings in various stages of human immunodeficiency virus infection . Arch Neurol . 1988;45:954-958.Crossref 17. Cheng-Mayer C, Levy JA. Distinct biological and serological properties of human immunodeficiency virus from the brain . Ann Neurol . 1988; 23( (suppl) ):58-61.Crossref 18. Anand R. Natural variants of human immunodeficiency virus from patients with neurological disorders do not kill T4+ cells . Ann Neurol . 1988;23( (suppl) ):66-70.Crossref 19. Resnick L, Berger JR, Shapshak P, Tourtellotte WW. Early penetration of the blood-brain-barrier by HIV . Neurology . 1988;38:9-14.Crossref 20. Farrell MA, Kaufmann JCE, Gilbert JJ, Noseworthy JH, Armstrong HA, Ebers GC. Oligoclonal bands in multiple sclerosis: clinical pathological correlation . Neurology . 1985;35:212-218.Crossref 21. Weber JN, Weiss RA, Roberts C. Human immunodeficiency virus infection in two cohorts of homosexual men: neutralizing sera and association of antigag antibody with prognosis . Lancet . 1987;1:119-122.Crossref 22. Lange J, Goudsmit J. Decline of antibody reactivity to HIV core protein secondary to increased production of HIV antigen . Lancet . 1987;1:448.Crossref 23. Epstein LG, Goudsmit J, Paul DA, et al. Expression of human immunodeficiency virus in cerebrospinal fluid of children with progressive encephalopathy . Ann Neurol . 1987;21:397-401.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1990

References