title: Cerebrospinal fluid mononuclear cell counts influence CSF HIV-1 RNA levels.
abstract: This study evaluated the relation between cerebrospinal fluid (CSF) mononuclear cells (MNC) and CSF HIV-1 RNA levels. HIV-1 RNA levels in plasma and CSF were analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in 58 consecutive patients with neurologic symptoms and late HIV-1 infection. The majority of the patients had no central nervous system (CNS) complication (n = 36), 11 had AIDS dementia complex (ADC) and 11 had CNS opportunistic infection (CNS OI). CSF cell counts were analyzed using a method that also evaluated hypocellular CSF (i.e., from 0.1 x 10(6) cells/L). A strong correlation was found between CSF MNC and CD4+ lymphocyte counts in blood (r = 0.58; p < .0001). HIV-1 RNA was detected in all plasma samples and in 38 of 58 (66%) of the cell-free CSF samples. CSF HIV-1 RNA was less frequently detected in patients with hypocellular CSF than in patients with normocellular or pleocytic CSF (13 of 28 patients [46%] versus 10 of 14 patients [71%] versus 15 of 16 patients [94%], respectively). The levels of CSF HIV-1 RNA correlated with the CSF MNC count (r = 0.61; p < .0001). The correlation also remained strong within the clinical subgroups of CNS asymptomatic patients (r = 0.55; p < .001) and ADC patients (r = 0.79; p < .001), but not among CNS OI patients (r = 0.19). Patients with CNS OI were found to have higher CSF HIV-1 RNA levels than the patients without evidence of CNS complication. Thus, a close relation was found between CSF HIV-1 RNA levels and CSF MNC counts. These data support the hypothesis that a substantial part of the virus in the CSF of HIV-1-infected patients is locally produced by CSF MNC.
authors.affiliation: Department of Neurology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: J
authors.initials: J
authors.lastname: Albert
authors.forename: P
authors.initials: P
authors.lastname: Hansson
authors.forename: P
authors.initials: P
authors.lastname: Pehrsson
authors.forename: H
authors.initials: H
authors.lastname: Link
authors.forename: A
authors.initials: A
authors.lastname: Sönnerborg
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid / Q000276:immunology / Q000821:virology; D017088:AIDS-Related Opportunistic Infections / Q000134:cerebrospinal fluid / Q000276:immunology / Q000821:virology; D000328:Adult; D018791:CD4 Lymphocyte Count; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000276:immunology / Q000821:virology; D002555:Cerebrospinal Fluid / Q000166:cytology* / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000134:cerebrospinal fluid* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*
chemical_list: D012367:RNA, Viral