Sinclair E, Gray F, Ciardi A, Scaravilli F
Department of Neuropathology, National Hospital, London, Great Britain.
J Neuropathol Exp Neurol. 1994 Jan;53(1):43-50. doi: 10.1097/00005072-199401000-00006.
The stage of HIV infection at which the virus enters the nervous system remains poorly understood. Examination of brains of HIV-positive non-AIDS patients often shows lymphocytic meningitis, myelin pallor and gliosis, but no immunohistochemical (IHC) evidence of the virus. In this study we have examined a number of brains from HIV-positive patients with (23) and without (8) AIDS as well as brains from 5 HIV-negative controls by morphological, morphometric, IHC and polymerase chain reaction (PCR) methods in an attempt to establish at what stage of the infection HIV can be detected in the brain and to correlate its presence with the pathological changes in the cortex. HIV-1 proviral DNA was found by PCR in the cortex of the majority of AIDS and in 2 out of 8 non-AIDS cases. Astroglial reaction was observed in the cortex of the majority of AIDS brains but not in most of the non-AIDS brains which showed, in addition, a dramatic reduction of glial fibrillary acidic protein staining around blood vessels; moreover, in this group the density of microglial cells was higher than in the AIDS group. These results show that: 1) HIV proviral DNA can be found in the brains of HIV-positive non-AIDS patients; 2) in the same group there is an increase in density of microglial cells which 3) appears to be transient, since AIDS brains without neuropathology show a lower density of these cells. They also suggest that the status of 'immune reaction' existing in AIDS may predate this period.(ABSTRACT TRUNCATED AT 250 WORDS)
人们对HIV感染进入神经系统的阶段仍知之甚少。对HIV阳性非艾滋病患者的脑部检查常常显示出淋巴细胞性脑膜炎、髓鞘苍白和胶质增生，但没有病毒的免疫组织化学（IHC）证据。在本研究中，我们通过形态学、形态计量学、免疫组织化学和聚合酶链反应（PCR）方法，检查了23例患有艾滋病和8例未患艾滋病的HIV阳性患者的脑部，以及5例HIV阴性对照者的脑部，试图确定在感染的哪个阶段可以在脑中检测到HIV，并将其存在与皮质的病理变化相关联。通过PCR在大多数艾滋病患者的皮质以及8例非艾滋病患者中的2例中发现了HIV-1前病毒DNA。在大多数艾滋病患者的脑部皮质中观察到星形胶质细胞反应，但在大多数非艾滋病患者的脑部中未观察到，此外，非艾滋病患者脑部血管周围的胶质纤维酸性蛋白染色显著减少；而且，该组中的小胶质细胞密度高于艾滋病组。这些结果表明：1）在HIV阳性非艾滋病患者的脑中可以发现HIV前病毒DNA；2）在同一组中，小胶质细胞密度增加；3）这种增加似乎是暂时的，因为没有神经病理学表现的艾滋病患者脑部这些细胞的密度较低。这些结果还表明，艾滋病中存在的“免疫反应”状态可能在此阶段之前就已存在。（摘要截短至250字）
