Relationship of cerebrospinal fluid immune activation associated factors to HIV encephalitis.
OBJECTIVE
Because macrophages are the predominant immune cell and the predominant infected cell in the brains of patients with HIV encephalitis, we studied macrophage and immune activation-associated factors in the cerebrospinal fluid (CSF) from 39 autopsied AIDS cases for whom complete neuropathologic evaluation of the brain was available.


RESULTS
CSF HIV p24 antigen was present in less than one-third of cases (11 out of 39). Less than half of the autopsies with moderate to severe parenchymal infection by HIV had high levels of CSF p24, although all autopsies with elevated levels of HIV p24 had moderate to severe HIV encephalitis. Elevated levels of cytokines, beta 2-microglobulin, neopterin, and quinolinic acid were observed.


CONCLUSIONS
Although many of the CSF findings showed a strong correlation with each other, none showed a strong correlation with the severity of HIV infection of the brain itself. The absence of a close association between CSF abnormalities and HIV encephalitis could reflect the abundance of complicating opportunistic infections in these terminally ill patients or the inadequacy of CSF as a marker of basal ganglia involvement in HIV encephalitis. These findings complicate interpretation of clinical studies of CSF in patients with AIDS where neuropathologic evaluation is unavailable.
Wiley
C A
CA
Department of Pathology, University of California San Diego, La Jolla 92093-0612.
Achim
C L
CL
Schrier
R D
RD
Heyes
M P
MP
McCutchan
J A
JA
Grant
I
I
D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid* / Q000209:etiology / Q000276:immunology; D017088:AIDS-Related Opportunistic Infections / Q000134:cerebrospinal fluid / Q000276:immunology; D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001708:Biopterins / Q000031:analogs & derivatives / Q000134:cerebrospinal fluid; D002648:Child; D016207:Cytokines / Q000134:cerebrospinal fluid; D016655:HIV Core Protein p24 / Q000134:cerebrospinal fluid; D006801:Humans; D008264:Macrophages / Q000276:immunology; D008875:Middle Aged; D019798:Neopterin; D017378:Quinolinic Acid / Q000134:cerebrospinal fluid; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid
D015415:Biomarkers; D016207:Cytokines; D016655:HIV Core Protein p24; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin; D017378:Quinolinic Acid