Early involvement of the nervous system by human immune deficiency virus (HIV). A study of 79 patients.
We report on 79 patients of different stages of human immune deficiency virus (HIV) infection according to the Walter-Reed staging classification (WR). Comparing the HIV antibody content per weight IgG in serum and cerebrospinal fluid (CSF), 54 patients (68%) showed higher antibody activity in CSF than in serum, indicating intrathecal antibody production and thus a local challenge with the virus. The percentage of patients with these antibodies in CSF increased from stage WR 1 (33%) to WR 5 (90%). It decreased again in WR 6 (68%). Twenty-one patients with intrathecally produced antibodies but without evidence for opportunistic or preexistent neuropsychiatric diseases were further analyzed. Even in stages WR 1 and 2 these patients showed distinct clinical signs. These consisted mostly in apathic personality change (n = 13), peripheral neuropathy (n = 8) or mild hemisyndrome (n = 9). Progression to severe dementia solely caused by HIV encephalitis seems to be possible. More often acceleration of the mental disorder indicates a synergistic action of other pathogens. Our study gives further evidence for very frequent, early and clinically active involvement of the nervous system by the HIV infection.
Diederich
N
N
Universitäts-Nervenklinik Köln, Schwerpunkt Neurologie, FRG.
Ackermann
R
R
Jürgens
R
R
Ortseifen
M
M
Thun
F
F
Schneider
M
M
Vukadinovic
I
I
D000163:Acquired Immunodeficiency Syndrome / Q000145:classification / Q000150:complications* / Q000276:immunology; D000328:Adult; D000914:Antibodies, Viral / Q000134:cerebrospinal fluid / Q000378:metabolism; D001927:Brain Diseases / Q000209:etiology / Q000382:microbiology*; D001932:Brain Neoplasms / Q000209:etiology*; D003072:Cognition Disorders / Q000209:etiology / Q000382:microbiology; D004660:Encephalitis / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008223:Lymphoma / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000382:microbiology*; D013116:Spinal Cord / Q000276:immunology; D014777:Virus Diseases / Q000209:etiology
D000914:Antibodies, Viral