Wiley C A, Belman A L, Dickson D W, Rubinstein A, Nelson J A
Department of Pathology, University of California San Diego, La Jolla 92093.
Clin Neuropathol. 1990 Jan-Feb;9(1):1-6.
Infants and children with symptomatic human immunodeficiency virus (HIV) infection frequently develop neurologic disease with symptoms and signs of acquired microcephaly, developmental delays, encephalopathy, pyramidal tract signs, and less often, movement disorders and ataxia. However, clinical courses vary and, based upon progression of neurologic findings, we have classified them into 2 broad categories; progressive (loss of previously acquired language and cognitive skills) and plateau (failure to acquire additional developmental skills). We have used immunocytochemistry to localize HIV within the brains of neurologically involved children with AIDS. Interestingly, the brains of those children with a progressive neurologic course showed readily detectable HIV antigen, while those with a plateau course showed little or no detectable HIV. These findings suggest that in children with symptomatic HIV infection, the progressive neurologic deterioration is due to continued presence of HIV within deep white matter and gray matter, while the plateau neurologic course is due to HIV induced damage followed by either limited penetration of virus into the central nervous system, or clearance of virus below detectable limits.
有症状的人类免疫缺陷病毒（HIV）感染的婴幼儿经常会出现神经系统疾病，伴有小头畸形、发育迟缓、脑病、锥体束征等症状和体征，较少出现运动障碍和共济失调。然而，临床病程各不相同，根据神经系统检查结果的进展情况，我们将其分为两大类：进行性（丧失先前获得的语言和认知技能）和平台期（未能获得额外的发育技能）。我们利用免疫细胞化学技术在患有艾滋病且神经系统受累的儿童大脑中定位HIV。有趣的是，那些病程呈进行性的儿童大脑中可轻易检测到HIV抗原，而病程呈平台期的儿童大脑中几乎检测不到或根本检测不到HIV。这些发现表明，在有症状的HIV感染儿童中，进行性神经功能恶化是由于HIV持续存在于深部白质和灰质中，而平台期神经病程是由于HIV诱导损伤，随后要么病毒对中枢神经系统的穿透有限，要么病毒清除至检测限以下。
