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- Document 0850
- DOCN M9620850
- TI Quantifying HIV-1 RNA using the polymerase chain reaction on
- cerebrospinal fluid and serum of seropositive individuals with and
- without neurologic abnormalities.
- DT 9602
- AU Conrad AJ; Schmid P; Syndulko K; Singer EJ; Nagra RM; Russell JJ;
- Tourtellotte WW; Neurology Services, VA Medical Center West Los
- Angeles,; California 90073, USA.
- SO J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Dec 1;10(4):425-35.
- Unique Identifier : AIDSLINE MED/96074275
- AB We quantified HIV-1 RNA levels (copies per milliliter) in cerebrospinal
- fluid (CSF) and serum from subjects at various stages of HIV-1 disease
- and determined the relationship of RNA levels to clinical and neurologic
- disease status (HND) and to laboratory values. Ninety-seven
- HIV-1-seropositive men without CNS opportunistic infections, tumors, or
- neurosyphilis and 13 high-risk seronegative controls were included in
- the study. Each individual underwent a structured interview and physical
- and neurologic examinations, followed by standardized collection of
- blood and CSF. A custom-designed, fully automated polymerase chain
- reaction (PCR) system was used to perform a minimum of four separate
- amplifications per specimen, using two HIV-1 gag primer pairs. Southern
- blotting followed by hybridization with product-specific probes was used
- for post-PCR detection. The number of copies per milliliter was
- determined by relating unknowns to a built-in dilution-series standard
- curve using an image analysis system. HIV-1 RNA was detectable in 96% of
- the sera, 78% of the concentrated CSF samples, and 54% of the
- unconcentrated CSF samples. Serum RNA levels were significantly higher
- than in CSF. Serum RNA levels were significantly inversely correlated
- with CD4+ cell counts (p = -0.34; p = 0.03): i.e., higher RNA levels in
- seropositive subjects were associated with lower numbers of CD4+ cells.
- Serum RNA levels correlated positively with number of AIDS-related
- symptoms, dysfunction scores for total neurological examination, mental
- status score, cranial nerve score, and CNS motor signs score. Serum RNA
- levels did not correlate significantly with length of time on zidovudine
- therapy, intrathecal IgG synthesis rate, or albumin leakage. RNA levels
- in CSF significantly correlated only with intrathecal IgG synthesis rate
- and with serum RNA levels. These results confirm that serum levels of
- HIV-1 RNA correlate with HND and inversely correlate with CD4 counts,
- demonstrating that HND occurs predominantly in late stages of HIV-1
- disease, although HIV-1 RNA can be detected in CSF from a majority of
- HIV-1-seropositive individuals at all stages of disease, which suggests
- that there can be early penetration of HIV into the CNS. However, HND
- can occur in the absence of high levels of CSF HIV-1 RNA. We also found
- that the concentration of HIV-1 in CSF is correlated with intrathecal
- IgG synthesis rate.
- DE Adult AIDS Dementia Complex/BLOOD/CEREBROSPINAL FLUID/*DIAGNOSIS Base
- Sequence Blotting, Southern Cerebrospinal Fluid/VIROLOGY CD4
- Lymphocyte Count CD4-Positive T-Lymphocytes/VIROLOGY DNA
- Primers/CHEMISTRY Gene Products, gag Human HIV
- Seropositivity/BLOOD/CEREBROSPINAL FLUID/*DIAGNOSIS
- HIV-1/*GENETICS/ISOLATION & PURIF Male Molecular Sequence Data
- Polymerase Chain Reaction/*METHODS RNA, Viral/*BLOOD/*CEREBROSPINAL
- FLUID Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S.
- JOURNAL ARTICLE
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-