Spectrum of Cerebrospinal Fluid Findings in Various Stages of Human Immunodeficiency Virus Infection

doi:10.1001/archneur.1988.00520330032007

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Vol. 45 No. 9, September 1988

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Spectrum of Cerebrospinal Fluid Findings in Various Stages of Human Immunodeficiency Virus Infection

Douglas W. Marshall, MD; Robin L. Brey, MD; William T. Cahill, MD; Richard W. Houk, MD; Robert A. Zajac, MD; Richard N. Boswell, MD

Arch Neurol. 1988;45(9):954-958.

Abstract

• This report summarizes the results of neurologic andcerebrospinal fluid (CSF) study findings in over 400 of the649 human immunodeficiency virus-infected US Air Force personnel,evaluated as of Dec 31, 1987. Eighty percent of these patientswere entirely asymptomatic and immunologically normal, 13% hadlow T-helper lymphocyte counts and/or cutaneous anergy, andonly 7% had opportunistic infection. Sixty-three percent ofall patients had some CSF abnormality. Sixty percent of theasymptomatic group had at least one abnormal result, over 25%had three or four CSF abnormalities, and over 7% had five orsix abnormal values. When patients with evidence of blood-brainbarrier leak were excluded, significant differences were seenbetween disease groups with regard to CSF glucose, CSF IgG levels,and CSF IgG synthesis. No human immunodeficiency virus-relatedcentral nervous system abnormalities were found on neurologicexamination in immunologically intact asymptomatic patientsregardless of CSF findings. No clear-cut predictor of impendingcentral nervous system complications has, as yet, been identifiedfrom the CSF parameters studied.

Author Affiliations

From the Departments of Neurology (Drs Marshall, Brey, and Cahill), Rheumatology (Dr Houk), and Medicine (Dr Boswell) and the Human Immunodeficiency Virus Unit (Dr Zajac), US Air Force (USAF) Medical Center, Lackland Air Force Base (AFB), Tex.

Footnotes

Accepted for publication May 3, 1988.

The views expressed herein are those of the authors and do notnecessarily reflect the views of the US Air Force or the Departmentof Defense.

Reprint requests to SGHMN, Wilford Hall USAF Medical Center,Lackland AFB, TX 78236-5300 (Dr Marshall).

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