       Document 0030
 DOCN  M9610030
 TI    AIDS dementia complex and HIV-1 brain infection: clinical-virological
       correlations [see comments]
 DT    9601
 AU    Brew BJ; Rosenblum M; Cronin K; Price RW; Department of Neurology, St.
       Vincent's Hospital, Sydney,; Australia.
 SO    Ann Neurol. 1995 Oct;38(4):563-70. Unique Identifier : AIDSLINE
       MED/96001212
 CM    Comment in: Ann Neurol 1995 Oct;38(4):559-60
 AB    To evaluate the presence and distribution of central nervous system
       infection by human immunodeficiency virus type 1 (HIV-1), we used
       immunohistochemical methods to map the HIV-1 p24 core protein in the
       brains of 55 autopsied patients with acquired immunodeficiency syndrome
       (AIDS). In a subset of 40 of these patients who had undergone antemortem
       neurological evaluation of the AIDS dementia complex (ADC), we analyzed
       the relation between the severities of the viral infection and clinical
       dysfunction. Viral antigen was detected in macrophages and cells with
       morphological and immunohistochemical characteristics of microglia as
       well as multinucleated cells. The distribution of antigen-positive cells
       preferentially involved certain deep brain structures, especially the
       globus pallidus, other basal ganglia nuclei, and the central white
       matter. Overall, the presence and frequency of infected cells were
       highly correlated with the histological findings of multinucleated-cell
       encephalitis and in general with the clinical ADC stage. However,
       infection was often more limited than might be anticipated from the
       severity of patients' clinical dysfunction: Only 61% of patients with at
       least ADC stage 1 had detectable antigen and of these only approximately
       30% of the brain sections were antigen positive. These results suggest a
       pathogenetic model of ADC where virus- or cell-coded toxins amplify the
       effect of limited brain infection.
 DE    Adult  AIDS Dementia Complex/PATHOLOGY/*VIROLOGY
       Brain/PATHOLOGY/*VIROLOGY  Female  Human  HIV Antigens/ANALYSIS  HIV
       Core Protein p24/ANALYSIS  *HIV-1  Immunohistochemistry  Male  Middle
       Age  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).

