Abstract
Thirty-seven matched cerebrospinal fluid (CSF) and plasma samples from 34 human immunodeficiency virus type 1 (HIV-1)-infected patients with suspected meningitis were analyzed for levels of HIV-1 RNA and markers of inflammation. Patients with tuberculous (n = 9) or cryptococcal (n = 6) meningitis had the highest CSF virus loads, which in many cases exceeded the levels in plasma, compared with patients with meningococcal meningitis (n = 3), aseptic meningitis (n = 8), tuberculoma (n = 2), or AIDS dementia complex (n = 4) or with normal lumbar punctures (n = 3). CSF virus load correlated significantly with the number of infiltrating lymphocytes (r = .60, P < .001) but not with plasma virus load, the levels of beta2-microglobulin in the CSF, or the integrity of the blood-brain barrier. These data suggest significant intrathecal HIV-1 replication in patients with lymphocytic meningeal infections such as tuberculous and cryptococcal meningitis.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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AIDS Dementia Complex / blood
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AIDS Dementia Complex / cerebrospinal fluid
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AIDS Dementia Complex / immunology
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Blood-Brain Barrier
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CD4 Lymphocyte Count
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Cryptococcosis / blood
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Cryptococcosis / cerebrospinal fluid
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Cryptococcosis / immunology
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HIV Core Protein p24 / analysis
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HIV Infections / blood
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HIV Infections / cerebrospinal fluid*
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HIV Infections / immunology
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HIV-1 / genetics
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HIV-1 / isolation & purification*
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Humans
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Leukocyte Count
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Lymphocytes / immunology
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Meningitis / blood
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Meningitis / cerebrospinal fluid*
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Meningitis / virology*
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Meningitis, Aseptic / blood
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Meningitis, Aseptic / cerebrospinal fluid
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Meningitis, Aseptic / immunology
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Meningitis, Fungal / blood
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Meningitis, Fungal / cerebrospinal fluid
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Meningitis, Fungal / immunology
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Meningitis, Meningococcal / blood
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Meningitis, Meningococcal / cerebrospinal fluid
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Meningitis, Meningococcal / immunology
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RNA, Viral / analysis
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RNA, Viral / isolation & purification*
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Tuberculosis, Meningeal / blood
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Tuberculosis, Meningeal / cerebrospinal fluid
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Tuberculosis, Meningeal / immunology
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Viral Load
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beta 2-Microglobulin / analysis
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beta 2-Microglobulin / metabolism
Substances
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HIV Core Protein p24
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RNA, Viral
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beta 2-Microglobulin