Virologic markers of human immunodeficiency virus type 1 in cerebrospinal fluid of infected children.
To identify virologic correlates associated with central nervous system (CNS) abnormalities in children infected with human immunodeficiency virus type 1 (HIV-1), cerebrospinal fluid (CSF) was examined for virologic markers and correlated with neurodevelopmental status and neuroimaging abnormalities. Of 30 children, 18 (60%) had at least 1 culture-positive CSF sample; in total, 21 (55%) of 38 CSF specimens were culture-positive. CSF white blood cell counts were higher in specimens that were culture-positive (P = .01). HIV-1 RNA was detected in 90% of CSF samples, and RNA levels > or = 10,000 copies/mL were found in 6 (75%) of 8 children with severe neurocognitive impairment (P = .08) and 11 (73%) of 15 children with a cognitive index < or = 85 (P = .04). Higher RNA levels were associated with abnormal brain imaging scans (P = .04) and with neurocognitive deficits (P = .04). Thus, HIV-1 is present within the CNS of most infected children, and neurocognitive impairment appears to be associated with increased HIV-1 replication.
Pratt
R D
RD
Department of Pediatrics, University of California, San Diego, La Jolla 92093-0672, USA.
Nichols
S
S
McKinney
N
N
Kwok
S
S
Dankner
W M
WM
Spector
S A
SA
D000293:Adolescent; D015415:Biomarkers; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000150:complications / Q000821:virology*; D015658:HIV Infections / Q000097:blood / Q000134:cerebrospinal fluid* / Q000150:complications / Q000523:psychology; D015497:HIV-1 / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000134:cerebrospinal fluid; D014776:Virus Cultivation
D015415:Biomarkers; D012367:RNA, Viral