title: CSF, plasma viral load and HIV associated dementia.
abstract: Plasma viral burden has proven valuable in predicting the future course of systemic HIV related disease and the response to treatment. It is not known whether plasma or cerebrospinal fluid (CSF) viral burden can be used to predict onset of or response to treatment of nervous system disease. We propose a model of viral load mediated neurotoxicity underlying peripheral and central HIV associated neurological disease. The objective of this preliminary study was to assess the relationship of HIV associated neurological disease to quantitative viral load in plasma and CSF. 47 subjects (HIV- = 10, HIV+ = 37) participated in the study. Plasma and CSF samples were collected within a 3 h window. RT-PCR (Roche Amplicor Monitor) was utilized to assess HIV-1 RNA viral load in both plasma and cell free (centrifuged) CSF. Subjects underwent concurrent comprehensive neurological and neuropsychological evaluations. In general, systemic viral load, as measured in plasma, was greater than that found in cell free CSF. Cell free CSF HIV RNA viral load was significantly correlated with neurological dysfunction, whereas plasma viral load was not. The sole subject with an elevated CSF viral load (> 5 Log 10), had HIV associated dementia (HAD) on clinical examination.
authors.affiliation: Department of Neurology, University of North Carolina at Chapel Hill, 27599-7025, USA.
authors.forename: K
authors.initials: K
authors.lastname: Robertson
authors.forename: S
authors.initials: S
authors.lastname: Fiscus
authors.forename: C
authors.initials: C
authors.lastname: Kapoor
authors.forename: W
authors.initials: W
authors.lastname: Robertson
authors.forename: G
authors.initials: G
authors.lastname: Schneider
authors.forename: R
authors.initials: R
authors.lastname: Shepard
authors.forename: L
authors.initials: L
authors.lastname: Howe
authors.forename: S
authors.initials: S
authors.lastname: Silva
authors.forename: C
authors.initials: C
authors.lastname: Hall
mesh_terms: D015526:AIDS Dementia Complex / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid* / Q000302:isolation & purification*; D019562:Viral Load
chemical_list: D012367:RNA, Viral