Cerebrospinal fluid abnormalities in homosexual men with and without neuropsychiatric findings.
We have studied cerebrospinal fluid obtained from 38 homosexual or bisexual men participating in a prospective study of the neuropsychological disorders associated with human immunodeficiency virus (HIV) infection. Twenty-two subjects had neuropsychiatric findings and seropositivity, 11 asymptomatic subjects had seroconverted within 6 to 24 months, and 5 subjects were seronegative controls. Only 1 had acquired immunodeficiency syndrome-related complex, and none had the acquired immunodeficiency syndrome when initially studied. There was a high rate of cerebrospinal fluid abnormalities in men with neuropsychiatric findings, including pleocytosis (41%), elevated IgG and IgG index (47%), and oligoclonal bands (18%). Even in the absence of neuropsychiatric findings, the asymptomatic HIV-seropositive subjects frequently had spinal fluid abnormalities. Of those with neuropsychiatric findings, HIV p24 antigen was detectable in cerebrospinal fluid in only 1 individual, yet HIV was isolated in 11 of 16 (69%) compared to 2 of 7 (29%) of those without neuropsychiatric findings. The identification of cerebrospinal fluid abnormalities in individuals known to have become infected within 6 to 24 months supports the hypothesis that the nervous system is an early target for HIV.
McArthur
J C
JC
Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Cohen
B A
BA
Farzedegan
H
H
Cornblath
D R
DR
Selnes
O A
OA
Ostrow
D
D
Johnson
R T
RT
Phair
J
J
Polk
B F
BF
D000293:Adolescent; D000328:Adult; D002555:Cerebrospinal Fluid / Q000166:cytology* / Q000378:metabolism / Q000382:microbiology; D006678:HIV / Q000302:isolation & purification; D006679:HIV Seropositivity / Q000150:complications; D006716:Homosexuality; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007136:Immunoglobulins / Q000378:metabolism; D007958:Leukocyte Count; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*; D043025:Oligoclonal Bands; D011446:Prospective Studies
D007074:Immunoglobulin G; D007136:Immunoglobulins; D043025:Oligoclonal Bands