High human immunodeficiency virus type 1 RNA load in the cerebrospinal fluid from patients with lymphocytic meningitis

J Infect Dis. 1998 Feb;177(2):473-6. doi: 10.1086/517379.

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

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Dementia Complex / blood
  • AIDS Dementia Complex / cerebrospinal fluid
  • AIDS Dementia Complex / immunology
  • Blood-Brain Barrier
  • CD4 Lymphocyte Count
  • Cryptococcosis / blood
  • Cryptococcosis / cerebrospinal fluid
  • Cryptococcosis / immunology
  • HIV Core Protein p24 / analysis
  • HIV Infections / blood
  • HIV Infections / cerebrospinal fluid*
  • HIV Infections / immunology
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Humans
  • Leukocyte Count
  • Lymphocytes / immunology
  • Meningitis / blood
  • Meningitis / cerebrospinal fluid*
  • Meningitis / virology*
  • Meningitis, Aseptic / blood
  • Meningitis, Aseptic / cerebrospinal fluid
  • Meningitis, Aseptic / immunology
  • Meningitis, Fungal / blood
  • Meningitis, Fungal / cerebrospinal fluid
  • Meningitis, Fungal / immunology
  • Meningitis, Meningococcal / blood
  • Meningitis, Meningococcal / cerebrospinal fluid
  • Meningitis, Meningococcal / immunology
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification*
  • Tuberculosis, Meningeal / blood
  • Tuberculosis, Meningeal / cerebrospinal fluid
  • Tuberculosis, Meningeal / immunology
  • Viral Load
  • beta 2-Microglobulin / analysis
  • beta 2-Microglobulin / metabolism

Substances

  • HIV Core Protein p24
  • RNA, Viral
  • beta 2-Microglobulin