More precise determination of the cerebrospinal fluid IgG index.

The retrovirus that causes acquired immune deficiency syndrome (AIDS) is now designated the human immunodeficiency virus (HIV). The cerebrospinal fluid (CSF) of 27 children with HIV infection was assayed for intra-blood-brain barrier (IBBB) synthesis of HIV-specific antibodies and for the presence of HIV antigen. In this cohort, 11 children had a progressive encephalopathy (PE), 9 had a static encephalopathy (SE), and 7 had normal neurological findings (N). IBBB synthesis of HIV-specific antibodies was identified (using matched serum and CSF specimens) in 7 of 11 children with PE, 4 of 9 children with SE, and 2 of 7 children with N. HIV antigen was found (using a highly sensitive solid-phase enzyme immunoassay) in the CSF of 8 of 11 children with PE, none of the children with SE, and none of the 7 children with N. On the basis of these data, we conclude that: IBBB synthesis of HIV antibodies indicates invasion of the central nervous system but may reflect prior or current infection; and HIV antigen in CSF indicates viral expression and correlates with the occurrence of PE. These findings strongly implicate HIV as the causative agent of PE in these children. The assay for HIV antigen in the CSF may be of value in determining the prognosis of children with HIV infection and for evaluating the efficacy of therapeutic agents against this retrovirus.

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Expression of human immunodeficiency virus in cerebrospinal fluid of children with progressive encephalopathy

Epstein

Goudsmit

Paul

et al. 1987

Annals of Neurology

129

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Evaluation of central nervous system involvement in Lyme borreliosis patients with a solitary erythema migrans lesion

Kuiper

Jongh

Dam

et al. 1994

Eur. J. Clin. Microbiol. Infect. Dis.

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To determine whether early dissemination of Borrelia burgdorferi to the central nervous system occurs in stage I of Lyme borreliosis, neurological and cerebrospinal fluid examination was performed in 48 consecutive patients in whom the only sign of infection was a solitary erythema migrans lesion. Long-term follow-up after treatment with tetracycline was carried out by telephone interview. At presentation, neurological findings were normal in all 48 patients. Cerebrospinal fluid samples were obtained from 29 (60%) patients. Mild pleocytosis and mild impairment of the blood-brain barrier were present in four and one of these patients, respectively. No significant amount of tumor necrosis factor or interleukin 6 was found in the cerebrospinal fluid samples. Culture results of 13 cerebrospinal fluid samples were negative. Borrelia burgdorferi DNA was only detected by the polymerase chain reaction in one of two aliquots of the cerebrospinal fluid sample of one patient. None of 46 patients who were interviewed 12 to 51 (median 25) months after antibiotic treatment developed manifestations consistent with disseminated or chronic Lyme borreliosis. Thus, no compelling evidence was found for the presence of asymptomatic central nervous system involvement in patients with clinically localized Lyme borreliosis.

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Central nervous system involvement in early and late syphilis: The problem of asymptomatic neurosyphilis

Wolters

Hische

Tutuarima

et al. 1988

Journal of the Neurological Sciences

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More precise determination of the cerebrospinal fluid IgG index.

Cited by 6 publications

References 0 publications

Expression of human immunodeficiency virus in cerebrospinal fluid of children with progressive encephalopathy

Expression of human immunodeficiency virus in cerebrospinal fluid of children with progressive encephalopathy

Evaluation of central nervous system involvement in Lyme borreliosis patients with a solitary erythema migrans lesion

Central nervous system involvement in early and late syphilis: The problem of asymptomatic neurosyphilis

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