CEREBROSPINAL-FLUID HIV-1 P24 ANTIGEN AND CULTURE - SENSITIVITY AND SPECIFICITY FOR AIDS DEMENTIA COMPLEX

被引:13
作者
BREW, BJ [1 ]
PAUL, MO [1 ]
NAKAJIMA, G [1 ]
KHAN, A [1 ]
GALLARDO, H [1 ]
PRICE, RW [1 ]
机构
[1] MEM SLOAN KETTERING CANC CTR,DEPT NEUROL,NEW YORK,NY 10021
关键词
D O I
10.1136/jnnp.57.7.784
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We prospectively evaluated 94 patients with AIDS-dementia complex (ADC) and a smaller group of 27 patients with other HIV-1 related neurological conditions to determine the usefulness of cerebrospinal fluid (CSF) p24 antigen and HIV-1 culture in the diagnosis of ADC. The presence of ADC correlated with detectable CSF p24, but not with a positive culture. However, only 54% of the patients with severe or end stage (stages 3 and 4) ADC had detectable CSF p24 and only 25% had a positive culture. Among those with detectable CSF p24, there was no discernible relationship between the severity of ADC and the amount of CSF p24. The diagnostic sensitivity of CSF p24 in ADC was 21% whereas the specificity was 98%. CSF HIV-1 culture had a sensitivity of 30% and a specificity of 80%. To address the possibility of binding of p24 in immune complexes, thereby escaping detection, an acid hydrolysis procedure was performed on the CSF and serum samples. This did not, however, make an appreciable difference in the detection rate of p24. To delineate whether the finding of cell free virus in the CSF was associated with ADC, CSF culture for HIV-1 was performed on both cell depleted and cell associated fractions. It was uncommon for CSF to be culture positive in only the cell free fraction and there was no relationship to the presence or severity of ADC.
引用
收藏
页码:784 / 789
页数:6
相关论文
共 21 条
  • [1] CEREBROSPINAL-FLUID BETA-2 MICROGLOBULIN IN PATIENTS INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS
    BREW, BJ
    BHALLA, RB
    FLEISHER, M
    PAUL, M
    KHAN, A
    SCHWARTZ, MK
    PRICE, RW
    [J]. NEUROLOGY, 1989, 39 (06) : 830 - 834
  • [2] CEREBROSPINAL-FLUID NEOPTERIN IN HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION
    BREW, BJ
    BHALLA, RB
    PAUL, M
    GALLARDO, H
    MCARTHUR, JC
    SCHWARTZ, MK
    PRICE, RW
    [J]. ANNALS OF NEUROLOGY, 1990, 28 (04) : 556 - 560
  • [3] Brew BJ, 1988, ADV CONT NEUROLOGY, P1
  • [4] HUMAN IMMUNODEFICIENCY VIRUS-INFECTION OF THE BRAIN .1. VIRUS ISOLATION AND DETECTION OF HIV SPECIFIC ANTIBODIES IN THE CEREBROSPINAL-FLUID OF PATIENTS WITH VARYING CLINICAL CONDITIONS
    CHIODI, F
    SONNERBORG, A
    ALBERT, J
    GAINES, H
    NORKRANS, G
    HAGBERG, L
    ASJO, B
    STRANNEGARD, O
    FENYO, EM
    [J]. JOURNAL OF THE NEUROLOGICAL SCIENCES, 1988, 85 (03) : 245 - 257
  • [5] CHIODI F, 1986, LANCET, V2, P1276
  • [6] ISOLATION FREQUENCY OF HUMAN IMMUNODEFICIENCY VIRUS FROM CEREBROSPINAL-FLUID AND BLOOD OF PATIENTS WITH VARYING SEVERITY OF HIV INFECTION
    CHIODI, F
    ALBERT, J
    OLAUSSON, E
    NORKRANS, G
    HAGBERG, L
    SONNERBORG, A
    ASJO, B
    FENYO, EM
    [J]. AIDS RESEARCH AND HUMAN RETROVIRUSES, 1988, 4 (05) : 351 - 358
  • [7] CRONIN KC, 1989, 5TH INT AIDS C MONTR
  • [8] CONCENTRATIONS OF CSF PROTEINS AS A MEASURE OF BLOOD-BRAIN-BARRIER FUNCTION AND SYNTHESIS OF IGG WITHIN THE CNS IN NORMAL SUBJECTS FROM THE AGE OF 6 MONTHS TO 30 YEARS
    EEGOLOFSSON, O
    LINK, H
    WIGERTZ, A
    [J]. ACTA PAEDIATRICA SCANDINAVICA, 1981, 70 (02): : 167 - 170
  • [9] EXPRESSION OF HUMAN-IMMUNODEFICIENCY-VIRUS IN CEREBROSPINAL-FLUID OF CHILDREN WITH PROGRESSIVE ENCEPHALOPATHY
    EPSTEIN, LG
    GOUDSMIT, J
    PAUL, DA
    MORRISON, SH
    CONNOR, EM
    OLESKE, JM
    HOLLAND, B
    [J]. ANNALS OF NEUROLOGY, 1987, 21 (04) : 397 - 401
  • [10] GOUDSMIT J, 1986, LANCET, V2, P177