Gisslén M, Hagberg L, Fuchs D, Norkrans G, Svennerholm B
Department of Infectious Diseases, Göteborg University, Sweden.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Apr 1;17(4):291-5. doi: 10.1097/00042560-199804010-00001.
HIV-1 RNA and neopterin levels were observed longitudinally for 20 to 68 months (mean, 37.5 months) in cerebrospinal fluid (CSF) and serum in 15 HIV-1-infected patients not receiving antiretroviral treatment. During the course of infection the HIV-1 RNA levels increased significantly in CSF, from a mean of 3.08 to 3.51 log10 copies RNA/ml (p < .01). A significant positive correlation was found between the CSF levels of HIV-I RNA and neopterin (rs = 0.54; p < .001), which increased from 13.6 to 19.6 nmol/L (p < .01). No significant changes in HIV-1 RNA or neopterin levels were found in serum. We suggest that the increase of CSF viral load with time in HIV-1 infection triggers an intrathecal immune activation reflected by increased CSF levels of neopterin. These results are in accordance with the theory that a chronic immune stimulation within the central nervous system (CNS) is involved in the pathogenesis of neurologic HIV-1 disease.
在15名未接受抗逆转录病毒治疗的HIV-1感染患者中，对其脑脊液（CSF）和血清中的HIV-1 RNA及新蝶呤水平进行了长达20至68个月（平均37.5个月）的纵向观察。在感染过程中，CSF中的HIV-1 RNA水平显著升高，从平均3.08 log10拷贝RNA/ml增至3.51 log10拷贝RNA/ml（p < 0.01）。HIV-I RNA的CSF水平与新蝶呤之间存在显著正相关（rs = 0.54；p < 0.001），新蝶呤水平从13.6 nmol/L增至19.6 nmol/L（p < 0.01）。血清中的HIV-1 RNA或新蝶呤水平未发现显著变化。我们认为，HIV-1感染时CSF病毒载量随时间增加会引发鞘内免疫激活，这表现为CSF中新蝶呤水平升高。这些结果与中枢神经系统（CNS）内慢性免疫刺激参与神经HIV-1疾病发病机制的理论相符。
