Diagnostic value for culture of cerebrospinal fluid from HIV-1-infected individuals for opportunistic viruses: a prospective study.
OBJECTIVE
To investigate the diagnostic value of cerebrospinal fluid (CSF) culture for opportunistic viruses from HIV-1-infected individuals.


METHODS
A 4-year prospective study was conducted using a participant population consisting of 186 HIV-1-infected individuals without neurologic disease, 73 HIV-1-infected individuals with encephalopathy, myelopathy, and/or peripheral neuropathy, and 10 controls. CSF samples recovered at 1-year intervals were subjected to virus culture using technique commonly used in the clinical laboratory setting.


RESULTS
CSF samples obtained from only 15 of the 269 (5.6%) participants yielded an opportunistic virus upon culture. Cytomegalovirus, herpes simplex virus types 1 and 2, adenovirus, and presumptive enteroviruses were identified. No consistent correlation was observed between the detection of an opportunistic virus within a CSF sample and the presence or future development of neurologic disease. However, a significant correlation was observed between culture of virus from CSF and the future development of abnormal CD4+ (chi 2, P = 0.0286) and CD8+ (chi 2, P = 0.0018) lymphocyte counts in HIV-1-infected participants without neurologic disease.


CONCLUSIONS
These results show that culture of CSF to screen for opportunistic viruses is neither diagnostic nor predictive of neurologic disease in HIV-1-infected individuals. Nevertheless, the presence of virus within CSF may be an indicator of HIV-1-mediated immune dysfunction and a predictor for future development of abnormal CD4+ and/or CD8+ lymphocyte counts.
Dix
R D
RD
Department of Ophthalmology, University of Miami School of Medicine, Florida.
McCarthy
M
M
Berger
J R
JR
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D015496:CD4-Positive T-Lymphocytes; D016827:CD8 Antigens; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D015497:HIV-1; D006801:Humans; D007958:Leukocyte Count; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets; D014773:Virology / Q000379:methods; D014777:Virus Diseases / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology
D016827:CD8 Antigens