Brouwers P, Tudor-Williams G, DeCarli C, Moss H A, Wolters P L, Civitello L A, Pizzo P A
Pediatric Branch, National Cancer Institute, NIH Clinical Center, Bethesda, MD 20892-1928, USA.
AIDS. 1995 Jul;9(7):713-20. doi: 10.1097/00002030-199507000-00008.
To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests.
Consecutive case series.
Government medical research center.
Eighty-six previously untreated children with symptomatic HIV-1 disease.
CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01).
Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.
研究以CD4 +淋巴细胞百分比和p24抗原水平反映的HIV疾病阶段与通过计算机断层扫描（CT）脑扫描评分和神经行为测试测量的HIV相关中枢神经系统（CNS）异常之间的关系。
连续病例系列。
政府医学研究中心。
86名先前未接受治疗的有症状HIV-1疾病儿童。
CD4％测量值与总体CT脑扫描严重程度评分（r = -0.45；P <0.001）及其组成部分（皮质萎缩、白质异常和脑内钙化）显著相关；对于垂直感染和输血感染的儿童，其相关性程度相当。CD4％测量值也与认知功能的总体水平相关（r = 0.32；P <0.005）。此外，血清p24抗原水平可检测的患者（n = 39）的CT脑扫描比p24水平不可检测的患者（n = 20；CT异常评分为21.3对35.9；P <0.02）更异常；在皮质萎缩和钙化评分方面也发现了类似差异。p24水平也与总体CT脑扫描严重程度评分相关（r = 0.34；P <0.01）。
CT脑扫描异常程度和认知功能障碍水平与HIV-1疾病阶段显著相关，这通过CD4白细胞测量或p24抗原升高反映出来。CT脑扫描病变与HIV疾病标志物（CD4和p24）之间的关系表明，这些中枢神经系统异常很可能与HIV-1感染有关，并进一步支持了全身性疾病进展与中枢神经系统表现之间的相互作用是连续而非离散的这一假设。
