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M9480012.TXT
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1994-08-09
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Document 0012
DOCN M9480012
TI Cerebrospinal fluid human immunodeficiency virus type 1 (HIV-1) p24
antigen levels in HIV-1-related dementia.
DT 9410
AU Royal W 3rd; Selnes OA; Concha M; Nance-Sproson TE; McArthur JC;
Department of Neurology, Johns Hopkins University School of; Medicine,
Baltimore, MD.
SO Ann Neurol. 1994 Jul;36(1):32-9. Unique Identifier : AIDSLINE
MED/94296064
AB Human immunodeficiency virus type 1 (HIV-1) p24 antigen, a putative
marker of virus load, was assayed in 79 blood and 83 cerebrospinal fluid
(CSF) samples from 90 HIV-1-seropositive individuals with or without
dementia. Twenty-eight subjects had no evidence of neuropsychological
impairment, 17 had mild impairment without objective evidence of
dementia, and 45 were demented. HIV-1 p24 antigen was detected more
frequently in CSF samples from demented (19/40) than normal (1/26) or
mildly impaired (1/17) subjects and in 67% of individuals with
significant dementia (MSK stages 2-4). p24 Antigen was detected less
frequently in CSF from demented subjects on antiretroviral drugs than
untreated demented individuals. Overall, the sensitivity of the antigen
capture assay in CSF among demented individuals was 47.5%; the
specificity, 95.0%; positive predictive value, 90.4%; negative
predictive value, 66.1%; and the efficiency, 72.2%. A direct
relationship was also noted between the degree of cognitive impairment
and blood p24 antigen detection frequency and antigen concentration.
CD4+ blood lymphocyte counts were lower for demented individuals, and
HIV-1 p24 antigen was detected more frequently and p24 antigen
concentration was higher in blood and CSF from individuals with low CD4+
blood lymphocyte counts. beta 2-Microglobulin levels were higher in CSF
from demented subjects and correlated directly with CSF p24 antigen
concentration. However, in contrast to CD4+ blood lymphocyte counts and
beta 2-microglobulin levels, only p24 antigen concentration correlated
with dementia severity. Therefore, p24 antigen can be a useful marker
for dementia related to HIV-1 infection.
DE beta 2-Microglobulin/ANALYSIS Adult AIDS Dementia
Complex/BLOOD/*CEREBROSPINAL FLUID/DIAGNOSIS Female Human HIV Core
Protein p24/BLOOD/*CEREBROSPINAL FLUID/IMMUNOLOGY HIV
Seropositivity/BLOOD/CEREBROSPINAL FLUID/DIAGNOSIS Leukocyte Count
Male Prognosis Severity of Illness Index Support, U.S. Gov't, P.H.S.
T4 Lymphocytes/IMMUNOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).