Levels of Human Immunodeficiency Virus Type 1 RNA in Cerebrospinal Fluid Correlate with AIDS Dementia Stage

Abstract

The relationship between the presence and severity of AIDS dementia complex (ADC) and the levels of human immunodeficiency virus type 1 (HIV-1) RNA in cerebrospinal fluid (CSF) were assessed. Nineteen patients with ADC (stages 1-3), 6 without ADC (group 1), and 10 (group 2) without ADC but with cryptococcal meningitis or progressive multifocal leukoencephalopathy were studied. There was a significant relationship between increasing CSF virus burden and ADC severity (P = .0006) but not with plasma burden and ADC severity. In group 2, CSF HIV-1 RNA levels in patients with cryptococcal meningitis were elevated. These results show that CSF HIV-1 RNA concentrations correlate well with ADC severity but may also be increased by central nervous system infections, such as cryptococcal meningitis.

Analysis of correlation between cerebrospinal fluid and plasma HIV-1 RNA levels in patients with neurological opportunistic diseases

“…There was a correlation in the group of patients with poor immunity (CD4+ count lower than 200 cells/mm 3 ), but not in the group with a CD4+ count higher than 200 cells/mm 3 . However, the latter group showed a high correlation coefficient and level of significance close to 95% (r = 0.507 and p = 0.077) and consisted of only 12 patients for analysis.…”

“…The patients were also divided according to immunological state, measured by CD4+ lymphocyte count into those with a count higher (12 patients) and lower (58 patients) than 200 cells/mm 3 . A correlation between the two compartments was observed in patients with a CD4+ count lower than 200 cell/mm 3 (r = 0.507, p < 0.001) and no correlation was found in patients with a CD4+ count higher than 200 cells/mm 3 (r = 0.530, p = 0.077).…”

“…Some investigators found no correlation between CSF and plasma viral load (BREW et al 1997, ELLIS et al 1997, CINQUE et al 1998, MARTIN et al 1998, FOUDRAINE et al 1998, SCHRAGER et al 1998, ANTINORI et al 2002, while others did (McARTHUR et al 1997, BOSSI et al 1998, ROBERTSON et al 1998, GARCIA et al 1999. The lack of a correlation between the two compartments suggests that the presence of HIV-1 RNA may not simply be due to passive passage of the virus from blood to CSF but rather to intrathecal replication (CINQUE et al 1998, SMITH et al 2009).…”

Human Immunodeficiency Virus and the Central Nervous System

“…At the time, the CNS was considered to only be indirectly involved in the progression of HIV disease [24,25]. Today we know that the CNS and the immune system are major targets of HIV infection [24,26].…”

“…There is a direct relationship between the neurological complications, the phase of HIV infection, and the level of immunological involvement. Moreover it can occur simultaneously on multiple levels of the neuroaxis and can facilitate the coexistence of multiple complications [24,25,30].…”