Martin C, Albert J, Hansson P, Pehrsson P, Link H, Sönnerborg A
Department of Neurology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Mar 1;17(3):214-9. doi: 10.1097/00042560-199803010-00005.
This study evaluated the relation between cerebrospinal fluid (CSF) mononuclear cells (MNC) and CSF HIV-1 RNA levels. HIV-1 RNA levels in plasma and CSF were analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in 58 consecutive patients with neurologic symptoms and late HIV-1 infection. The majority of the patients had no central nervous system (CNS) complication (n = 36), 11 had AIDS dementia complex (ADC) and 11 had CNS opportunistic infection (CNS OI). CSF cell counts were analyzed using a method that also evaluated hypocellular CSF (i.e., from 0.1 x 10(6) cells/L). A strong correlation was found between CSF MNC and CD4+ lymphocyte counts in blood (r = 0.58; p < .0001). HIV-1 RNA was detected in all plasma samples and in 38 of 58 (66%) of the cell-free CSF samples. CSF HIV-1 RNA was less frequently detected in patients with hypocellular CSF than in patients with normocellular or pleocytic CSF (13 of 28 patients [46%] versus 10 of 14 patients [71%] versus 15 of 16 patients [94%], respectively). The levels of CSF HIV-1 RNA correlated with the CSF MNC count (r = 0.61; p < .0001). The correlation also remained strong within the clinical subgroups of CNS asymptomatic patients (r = 0.55; p < .001) and ADC patients (r = 0.79; p < .001), but not among CNS OI patients (r = 0.19). Patients with CNS OI were found to have higher CSF HIV-1 RNA levels than the patients without evidence of CNS complication. Thus, a close relation was found between CSF HIV-1 RNA levels and CSF MNC counts. These data support the hypothesis that a substantial part of the virus in the CSF of HIV-1-infected patients is locally produced by CSF MNC.
本研究评估了脑脊液（CSF）单核细胞（MNC）与脑脊液HIV-1 RNA水平之间的关系。采用逆转录-聚合酶链反应（RT-PCR）对58例有神经症状且处于HIV-1感染晚期的连续患者的血浆和脑脊液中的HIV-1 RNA水平进行了分析。大多数患者无中枢神经系统（CNS）并发症（n = 36），11例患有艾滋病痴呆综合征（ADC），11例患有CNS机会性感染（CNS OI）。使用一种也能评估低细胞脑脊液（即每升0.1×10⁶个细胞）的方法对脑脊液细胞计数进行了分析。发现脑脊液MNC与血液中CD4⁺淋巴细胞计数之间存在强相关性（r = 0.58；p <.0001）。在所有血浆样本以及58份无细胞脑脊液样本中的38份（66%）中检测到了HIV-1 RNA。与细胞数量正常或细胞增多的脑脊液患者相比，低细胞脑脊液患者中脑脊液HIV-1 RNA的检测频率更低（分别为28例患者中的13例[46%]、14例患者中的10例[71%]以及16例患者中的15例[94%]）。脑脊液HIV-1 RNA水平与脑脊液MNC计数相关（r = 0.61；p <.0001）。在CNS无症状患者（r = 0.55；p <.001）和ADC患者（r = 0.79；p <.001）的临床亚组中，这种相关性也很强，但在CNS OI患者中不存在相关性（r = 0.19）。发现患有CNS OI的患者脑脊液HIV-1 RNA水平高于无CNS并发症证据的患者。因此，发现脑脊液HIV-1 RNA水平与脑脊液MNC计数之间存在密切关系。这些数据支持了以下假设：HIV-1感染患者脑脊液中的大量病毒是由脑脊液MNC在局部产生的。
