title: Cerebrospinal fluid abnormalities in patients without AIDS who are seropositive for the human immunodeficiency virus.
abstract: Lumbar punctures were done on 114 consecutive active duty patients referred for evaluation of positive tests for antibodies to the human immunodeficiency virus (HIV). Eighty-eight percent of these patients appeared to have early HIV infections, as evidenced by intact delayed hypersensitivity, T helper lymphocyte counts greater than 400/mm3, and lack of constitutional symptoms. Forty-four (38.6%) of the patients met our criteria for abnormal cerebrospinal fluid (CSF); another 13 (11.4%) had borderline elevations of nucleated cells or protein and could not be definitely classified as having normal or abnormal CSF. No significant differences existed between the patients with normal and abnormal CSF with regard to age; sex; race; serum FTA-Abs; clinical staging; absolute T helper lymphocyte counts; or cytomegalovirus, Toxoplasma, or Epstein-Barr virus serologies. Seventy-two percent of the patients with abnormal CSF had evidence of possible viral infection of the central nervous system (CNS), as evidenced by increased CSF IgG, increased IgG synthesis rates, or the presence of oligoclonal bands. We found that a significant percentage of asymptomatic patients with apparent early HIV infections have abnormal CSF that is possibly due to CNS involvement by HIV.
authors.affiliation: Department of Internal Medicine, Wilford Hall U.S. Air Force Medical Center, Lackland Air Force Base, Texas 78236-5300.
authors.forename: M E
authors.initials: ME
authors.lastname: Appleman
authors.forename: D W
authors.initials: DW
authors.lastname: Marshall
authors.forename: R L
authors.initials: RL
authors.lastname: Brey
authors.forename: R W
authors.initials: RW
authors.lastname: Houk
authors.forename: D C
authors.initials: DC
authors.lastname: Beatty
authors.forename: R E
authors.initials: RE
authors.lastname: Winn
authors.forename: G P
authors.initials: GP
authors.lastname: Melcher
authors.forename: M G
authors.initials: MG
authors.lastname: Wise
authors.forename: C V
authors.initials: CV
authors.lastname: Sumaya
authors.forename: R N
authors.initials: RN
authors.lastname: Boswell
mesh_terms: D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications; D006679:HIV Seropositivity / Q000134:cerebrospinal fluid* / Q000150:complications / Q000276:immunology; D006566:Herpesviridae Infections / Q000150:complications; D004854:Herpesvirus 4, Human; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid; D009460:Neurologic Examination; D009494:Neurosyphilis / Q000150:complications; D011581:Psychological Tests; D014123:Toxoplasmosis / Q000150:complications
chemical_list: D007136:Immunoglobulins