Field M, Tate J, Kunze H, Frazer I H
Department of Psychology, University of Queensland, Princess Alexandra Hospital, Australia.
Aust N Z J Med. 1989 Dec;19(6):694-9. doi: 10.1111/j.1445-5994.1989.tb00337.x.
Twelve asymptomatic HIV seropositive subjects ages 21 to 40 years were examined for serologic evidence of cerebral HIV infection, for cerebral structural abnormalities, and for neuropsychologic evidence of cerebral dysfunction using standard methods. Eleven of the 12 had antibody to HIV in the cerebrospinal fluid (CSF). Nine subjects had oligoclonal immunoglobulins in the CSF, of whom five had some for which there were no corresponding serum oligoclonal immunoglobulins ('unique' oligoclonal immunoglobulins). Intracerebral synthesis of HIV specific antibodies was demonstrated for four subjects. Significant deficits of memory and frontal lobe function were found in five of the 12 subjects. Subjects who had oligoclonal immunoglobulins unique to the CSF all had significant neuropsychological abnormalities. No structural cerebral abnormalities were demonstrated using CT scanning for any subject tested. These results support other evidence that HIV is neurotropic and capable of directly inducing brain damage even in immunologically normal subjects. Tests of memory and frontal lobe function are frequently abnormal in patients with early HIV infection, and identify as abnormal a similar group of patients to immunological or biochemical tests which might indicate cerebral HIV infection.
对12名年龄在21至40岁之间无症状的HIV血清学阳性受试者，采用标准方法检查其脑内HIV感染的血清学证据、脑结构异常以及脑功能障碍的神经心理学证据。12名受试者中有11名脑脊液（CSF）中存在HIV抗体。9名受试者脑脊液中有寡克隆免疫球蛋白，其中5名存在一些血清中没有相应寡克隆免疫球蛋白的情况（“独特”寡克隆免疫球蛋白）。4名受试者证实有脑内HIV特异性抗体的合成。12名受试者中有5名存在明显的记忆和额叶功能缺陷。脑脊液中具有独特寡克隆免疫球蛋白的受试者均有明显的神经心理学异常。对所有接受检测的受试者进行CT扫描，均未发现脑结构异常。这些结果支持了其他证据，即HIV具有嗜神经性，即使在免疫正常的受试者中也能够直接导致脑损伤。在早期HIV感染患者中，记忆和额叶功能测试常常异常，并且能够识别出与可能提示脑内HIV感染的免疫学或生化测试结果相似的异常患者群体。
