Human immunodeficiency virus type 1 antigen in cerebrospinal fluid. Correlation with clinical neurologic status
P. Portegies, L. G. Epstein, S. T. Hung, J. de Gans and J. Goudsmit
Department of Neurology, University of Amsterdam, The Netherlands.
Human immunodeficiency virus type-1 (HIV-1) antigen was assayed in paired
serum/cerebrospinal fluid (CSF) specimen from 85 adults and 58 children
with acquired immunodeficiency syndrome and was compared with clinical
neurological status. A quantitative comparison of HIV-1 antigen levels in
matched serum and CSF specimens indicated that HIV-1 antigen expression in
these compartments is independent and is correlated with acquired
immunodeficiency syndrome dementia complex in adults and progressive
encephalopathy in children. In a longitudinal study (n = 47), 16 patients
tested positive for HIV-1 antigen in the CSF before (n = 2) or coincident
(n = 14) with neurological deterioration. Six patients who tested positive
for HIV-1 antigen in the CSF remained neurologically normal for a median
duration of follow-up of 11 months. Six of 25 patients who tested negative
for HIV-1 antigen in the CSF, subsequently showed neurological
deterioration. These data indicate that HIV-1 antigen expression in the CSF
is not useful in predicting neurological deterioration.
