Detection of HIV RNA levels in intraocular and cerebrospinal fluids in patients with AIDS-related cryptococcosis.
The objective of the present study was to evaluate human immunodeficiency virus (HIV) levels in the aqueous humor and vitreous fluid in patients with and those without ocular involvement due to AIDS-related cryptococcosis. We also assessed whether cryptococcosis infection in the central nervous system (CNS) was associated with elevated HIV levels in the cerebrospinal fluid (CSF). From 1993 to 2003, we obtained 16 CSF samples from 9 AIDS patients with cryptococcal meningitis and 7 AIDS patients without CNS opportunistic infection. Samples of intraocular fluids were obtained from all 9 patients with cryptococcal meningitis. Five cases presented with ocular involvement in patients with meningitis. By using the method of reverse transcriptase-polymerase chain reaction, we detected higher HIV loads in aqueous humor (27,244+/-4,123 copies/ml) and vitreous fluid (84,930+/-5,071 copies/ml) in patients with concomitant CNS and ocular involvement due to AIDS-related cryptococcosis (p<0.05). HIV levels in the vitreous fluid were correlated with levels in CSF (r=0.77). Mean HIV level in the CSF (209,761+/-18,787 copies/ml) was significantly elevated in AIDS patients with cryptococcoal meningitis (p<0.05). To our knowledge, this is the first report to study the level of HIV loads in the CSF and intraocular fluid simultaneously in AIDS patients with cryptococcosis. Our results revealed the intrathecal and intraocular HIV replication in patients with cryptococcosis.
Peng
Chi-Hsien
CH
Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Chen
Shih-Jen
SJ
Ho
Chi-Kung
CK
Ku
Hung-Hai
HH
Lin
Hon-Wun
HW
Chen
Steve S-L
SS
Wu
Chih-Chiau
CC
Chi
Chin-Wen
CW
Hsu
Wen-Ming
WM
Chiou
Shih-Hwa
SH
D017088:AIDS-Related Opportunistic Infections / Q000378:metabolism / Q000821:virology*; D000163:Acquired Immunodeficiency Syndrome / Q000378:metabolism / Q000821:virology; D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000378:metabolism / Q000821:virology*; D008875:Middle Aged; D012367:RNA, Viral / Q000134:cerebrospinal fluid* / Q000378:metabolism; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019562:Viral Load; D014822:Vitreous Body / Q000821:virology*
D012367:RNA, Viral