       Document 0033
 DOCN  M9620033
 TI    Immunocytochemical quantitation of human immunodeficiency virus in the
       brain: correlations with dementia.
 DT    9602
 AU    Glass JD; Fedor H; Wesselingh SL; McArthur JC; Department of Neurology,
       Johns Hopkins University, Baltimore, MD,; USA.
 SO    Ann Neurol. 1995 Nov;38(5):755-62. Unique Identifier : AIDSLINE
       MED/96074187
 AB    The pathogenesis of human immunodeficiency virus (HIV)-associated
       dementia is unclear, and the underlying pathological substrate has been
       a matter of debate. In a prospectively clinically characterized
       population of acquired immunodeficiency syndrome (AIDS) patients we
       investigated the relationship between the clinical syndrome of
       HIV-associated dementia and the presence and relative quantity of
       immunocytochemical markers for HIV-1 (gp41 antibody), and for
       macrophages and microglia (HAM-56 antibody). Sections from the basal
       ganglia and frontal lobes from the brains of 51 patients were studied,
       and the data were stratified for severity of dementia (16 nondemented,
       12 mildly demented, 23 severely demented), rate of dementia progression,
       duration of AIDS, use of antiretrovirals, and several other demographic
       features. We found a highly significant correlation between the degree
       of macrophage staining and the severity of dementia but only a
       borderline correlation between the presence and amount of gp41-positive
       cells and dementia. Several nondemented patients showed abundant gp41
       immunoreactivity, and some severely demented showed little to no gp41
       immunoreactivity. Other correlations with the immunostaining data,
       including antiretroviral use, were not significant. We conclude that the
       presence of macrophages and microglia is a better correlate with
       HIV-associated dementia than is the presence and amount of HIV-infected
       cells in the brain. These data support the concept that the pathogenesis
       of HIV-associated dementia is likely due to indirect effects of HIV
       infection of the brain, possibly through the actions of macrophages and
       microglia.
 DE    Adult  Analysis of Variance  Antibodies/ANALYSIS  AIDS Dementia
       Complex/DRUG THERAPY/MORTALITY/*VIROLOGY  Basal
       Ganglia/PATHOLOGY/VIROLOGY  Brain/IMMUNOLOGY/PATHOLOGY/*VIROLOGY  Female
       Frontal Lobe/PATHOLOGY/VIROLOGY  Human  HIV Envelope Protein
       gp41/*ANALYSIS  HIV-1/*ISOLATION & PURIF  Immunohistochemistry
       Macrophages/PATHOLOGY  Male  Microglia/PATHOLOGY  Middle Age
       Prospective Studies  RNA, Messenger/ANALYSIS  Support, Non-U.S. Gov't
       Support, U.S. Gov't, P.H.S.  Survival Analysis  Tumor Necrosis
       Factor/ANALYSIS  Zidovudine/THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

