title: Neurological symptoms during primary human immunodeficiency virus (HIV) infection correlate with high levels of HIV RNA in cerebrospinal fluid.
abstract: This analysis involves 22 patients with diagnosed symptomatic human immunodeficiency virus (HIV) infection. Neurologic symptoms were present in 11 patients, ranging from severe and persistent headache to clinical signs suggestive of meningitis. A strong correlation between neurological symptoms and cerebrospinal fluid (CSF) viral load was found. The mean CSF HIV ribonucleic acid (RNA) level was 4. 12 log for patients with neurological symptoms and 2.58 log for patients without neurological symptoms (P<.00001). Plasma viral load alone does not correlate or predict central nervous system (CNS) involvement. In our sample of patients, HIV RNA levels could be detected in most patients regardless of the presence of neurological symptoms. Moreover, early treatment including drugs with high levels of penetration in the CNS must be considered for patients with primary HIV infection.
authors.affiliation: Division of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milano, Italy. giuseppe.tambussi@hsr.it
authors.forename: G
authors.initials: G
authors.lastname: Tambussi
authors.forename: A
authors.initials: A
authors.lastname: Gori
authors.forename: B
authors.initials: B
authors.lastname: Capiluppi
authors.forename: C
authors.initials: C
authors.lastname: Balotta
authors.forename: L
authors.initials: L
authors.lastname: Papagno
authors.forename: B
authors.initials: B
authors.lastname: Morandini
authors.forename: M
authors.initials: M
authors.lastname: Di Pietro
authors.forename: D
authors.initials: D
authors.lastname: Ciuffreda
authors.forename: A
authors.initials: A
authors.lastname: Saracco
authors.forename: A
authors.initials: A
authors.lastname: Lazzarin
mesh_terms: D020805:Central Nervous System Viral Diseases / Q000276:immunology / Q000503:physiopathology* / Q000821:virology*; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D019562:Viral Load
chemical_list: D012367:RNA, Viral