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Departments of Dermatology and Pathology (Dr. Resnick), Mount Sinai Medical Center, Miami Beach, and the Departments of Neurology and Internal Medicine (Dr. Berger), University of Miami School of Medicine, Miami, FL; the Neurology and Research Services (Drs. Shapshak and Tourtellotte), Veterans Administration West Los Angeles Medical Center, Wadsworth Division and the Neurology Department (Dr. Shapshak), Reed Neurological Research Center, UCLA School of Medicine, Los Angeles; and the Pediatrics Department (Dr. Shapshak), Harbor-UCLA Medical Center, Torrance, CA.
CNS dysfunction occurs frequently in patients with HIV infection. To better define the role of HIV in the pathogenesis of neurologic dysfunction, HIV isolation and antibody studies were investigated from the CSF in 52 seropositive patients, 29 with and 23 without neurologic signs and symptoms, in various stages of disease development ranging from asymptomatic to ARC to AIDS. HIV was recovered from the CSF of 5 of 29 (17%) patients with neurologic signs and symptoms and 5 of 23 (22%) neurologically asymptomatic patients. All patients with positive CSF HIV cultures had antibodies directed against HIV p24 and gp41 in serum and CSF by Western blot analysis and elevated intra-blood-brain-barrier total IgG and HIV-specific IgG synthesis rates. The frequency of CSF HIV isolation from the group of seropositive patients without AIDS, 9 of 32 (28%), exceeded that of patients with AIDS, 1 of 20 (5%) (p < 0.05). These findings indicate that HIV infects the CNS early in the course of viral infection and prior to the development of HIV-associated neurologic abnormalities.
Address correspondence and reprint requests to Dr. Resnick, Departments of Dermatology and Pathology, Mount Sinai Medical Center, Miami Beach, FL 33140.
Supported in part by the Key Pharmaceuticals Medical Research and Educational Foundation of Miami, FL, US Army Medical Research and Development Command, Order No. 86PP6854, Veterans' Administration Merit Funds, and the Sophie and Nathan Gumenick Research Fund.
Received January 26, 1987. Accepted for publication in final form March 16, 1987.
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