Dissociation of AIDS-related vacuolar myelopathy and productive HIV-1 infection of the spinal cord.
Although merging clinically within the spectrum of the AIDS dementia complex, vacuolar myelopathy is a pathologically distinct entity detected in up to 30% of autopsied patients succumbing to the late complications of human immunodeficiency virus type 1 (HIV-1) infection. Using immunohistochemistry and in situ hybridization to detect an HIV-1 core protein and viral mRNA, respectively, in tissue sections, and culture isolation to assess infectious virus in tissue homogenates, we found that vacuolar myelopathy was independent of productive HIV-1 infection of the spinal cord and brain. These results indicate that AIDS-associated vacuolar myelopathy is either not related directly to spinal cord HIV-1 infection or involves nonproductive infection and pathobiological processes distinct from those responsible for the multinucleated-cell inflammatory infiltrates that serve as histopathologic markers of productive CNS HIV-1 infection.
Rosenblum
M
M
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Scheck
A C
AC
Cronin
K
K
Brew
B J
BJ
Khan
A
A
Paul
M
M
Price
R W
RW
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001921:Brain / Q000382:microbiology; D004660:Encephalitis / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D009693:Nucleic Acid Hybridization; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology; D014617:Vacuoles / Q000473:pathology
D012333:RNA, Messenger; D012367:RNA, Viral