Cerebrospinal fluid analysis in HIV-1-infected children: immunological and virological findings before and after AZT therapy.
Immunological and viral studies were conducted on cerebrospinal fluid from 31 HIV-1-infected children, of whom 23 were neurologically asymptomatic and 8 had progressive encephalopathy. After AZT treatment, a second cerebrospinal fluid specimen was obtained from 15 children, 11 of whom were neurologically asymptomatic and 4 had progressive encephalopathy. Virus isolation and p24Ag detection were more frequent in children with progressive encephalopathy than in asymptomatic children (66% versus 12%) and were inversely correlated with intrathecal HIV-1-antibody detection (anti-gag AB: 25% versus 70%). High concentrations of interleukin-1 beta (IL-1 beta) and IL-6 were found in children with progressive encephalopathy (50% and 37%, respectively), but low levels were also detected in some asymptomatic children (13% and 9%, respectively). Tumour necrosis factor-alpha (TNF alpha) was not found. AZT treatment induced disappearance of p24Ag in cerebrospinal fluid, as well as a marked reduction in cytokine levels. Cytokine determination may be useful in monitoring AZT treatment in children with progressive encephalopathy.
Department of Paediatrics, University of Padua School of Medicine, Padova, Italy.
A M
AM
Laverda
P
P
Gallo
A
A
De Rossi
S
S
Sivieri
P
P
Cogo
A
A
Pagliaro
L
L
Chieco-Bianchi
B
B
Tavolato
D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000276:immunology; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000276:immunology; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007223:Infant; D007375:Interleukin-1 / Q000134:cerebrospinal fluid; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid; D015215:Zidovudine / Q000627:therapeutic use*
D000914:Antibodies, Viral; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D015215:Zidovudine