title: Cerebrospinal fluid beta 2-microglobulin in patients with AIDS dementia complex: an expanded series including response to zidovudine treatment.
abstract: OBJECTIVE
  To determine the relationship between cerebrospinal fluid (CSF) beta 2-microglobulin (beta 2M) and severity of AIDS dementia complex (ADC), and between CSF beta 2M and response of ADC to zidovudine.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  Seventy-eight patients with varying stages of ADC were selected from a subgroup of a cohort of HIV-seropositive patients who are being studied prospectively for the neurological complications of HIV-1 infection. To enter our study, patients had to have an ADC stage of at least 0.5 (equivocal symptoms or abnormal neurological signs in the absence of functional impairment). A control group of 11 HIV-1-seropositive, neurologically normal patients was chosen randomly from the patients followed in the Multicenter AIDS Cohort Study.
  
  
  METHODS
  Patients were assessed neurologically and neuropsychologically and computed tomography of the brain and CSF studies were performed.
  
  
  METHODS
  Patients were staged according to severity of ADC on clinical criteria. Neuropsychological test scores were converted to an impairment score. CSF beta 2M was quantified in both serum and CSF of all patients and in 10 patients with pre- and post-zidovudine assessments.
  
  
  RESULTS
  There was a high correlation between CSF beta 2M concentration and severity of ADC (P less than 0.0001); treatment with zidovudine significantly reduced these concentrations (P = 0.013). CSF beta 2M concentration was independent of CSF white-cell count and blood-brain barrier impairment. Other CSF changes in the same patients (including blood-brain barrier permeability to albumin, intrathecal synthesis of immunoglobulin G and HIV-1-p24-antigen levels) were less useful as objective correlates of ADC severity and response to zidovudine therapy.
  
  
  CONCLUSIONS
  CSF beta 2M may be a valuable marker of ADC severity and response to antiviral therapy.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: B J
authors.initials: BJ
authors.lastname: Brew
authors.forename: R B
authors.initials: RB
authors.lastname: Bhalla
authors.forename: M
authors.initials: M
authors.lastname: Paul
authors.forename: J J
authors.initials: JJ
authors.lastname: Sidtis
authors.forename: J J
authors.initials: JJ
authors.lastname: Keilp
authors.forename: A E
authors.initials: AE
authors.lastname: Sadler
authors.forename: H
authors.initials: H
authors.lastname: Gallardo
authors.forename: J C
authors.initials: JC
authors.lastname: McArthur
authors.forename: M K
authors.initials: MK
authors.lastname: Schwartz
authors.forename: R W
authors.initials: RW
authors.lastname: Price
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D006801:Humans; D011446:Prospective Studies; D015215:Zidovudine / Q000627:therapeutic use*; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid*
chemical_list: D001613:beta 2-Microglobulin; D015215:Zidovudine