High Human Immunodeficiency Virus Type 1 RNA Load in the Cerebrospinal Fluid from Patients with Lymphocytic Meningitis

• Published in: The Journal of infectious diseases Vol. 177; no. 2; pp. 473 - 476
• Main Authors: Morris, Lynn, Silber, Eli, Sonnenberg, Pamela, Eintracht, Shaun, Nyoka, Stephina, Lyons, Susan F., Saffer, David, Koornhof, Hendrik, Martin, Desmond J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-02-1998; University of Chicago Press; Oxford University Press
• Subjects: AIDS Dementia Complex - blood; AIDS Dementia Complex - cerebrospinal fluid; AIDS Dementia Complex - immunology; AIDS/HIV; Aseptic meningitis; beta 2-Microglobulin - analysis; beta 2-Microglobulin - metabolism; Biological and medical sciences; Blood plasma; Blood-Brain Barrier; CD4 Lymphocyte Count; Cerebrospinal fluid; Concise Communications; Cryptococcosis - blood; Cryptococcosis - cerebrospinal fluid; Cryptococcosis - immunology; HIV 1; HIV Core Protein p24 - analysis; HIV Infections - blood; HIV Infections - cerebrospinal fluid; HIV Infections - immunology; HIV-1 - genetics; HIV-1 - isolation & purification; Human viral diseases; Humans; Infections; Infectious diseases; Leukocyte Count; Lymphocytes; Lymphocytes - immunology; Medical sciences; Meningeal tuberculosis; 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; Meningococcal meningitis; RNA; RNA, Viral - analysis; RNA, Viral - isolation & purification; Tuberculosis, Meningeal - blood; Tuberculosis, Meningeal - cerebrospinal fluid; Tuberculosis, Meningeal - immunology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Viruses; Human; Immunopathology; Opportunistic infection; Mycosis; RNA; HIV-1 virus; Cryptococcosis; Retroviridae; Lymphocytic meningitis; AIDS; Cerebrospinal fluid; Mycobacterial infection; Immune deficiency; Lentivirus; Infection; Virus; Viral disease; Central nervous system disease; Bacteriosis; Human immunodeficiency virus
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/517379

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 β2-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.