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Intrathecal immune activation is associated with cerebrospinal fluid markers of neuronal destruction in AIDS patients

Journal article
Authors Lars Hagberg
Dietmar Fuchs
Lars Rosengren
Magnus Gisslén
Published in J Neuroimmunol
Volume 102
Issue 1
Pages 51-5
Publication year 2000
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Clinical Neurosciences, Section of Experimental Neuroscience
Pages 51-5
Language en
Keywords AIDS-Related Opportunistic Infections/cerebrospinal fluid, Acquired Immunodeficiency Syndrome/*cerebrospinal, fluid/immunology/pathology/*physiopathology, Adult, Biological Markers/cerebrospinal fluid, Cell Death/physiology, Female, HIV/genetics, HIV Infections/cerebrospinal fluid, Humans, Immune System/*physiopathology, Male, Middle Aged, Neopterin/cerebrospinal fluid, Neurofilament Proteins/*cerebrospinal fluid, Neurons/*physiology, RNA, Viral/cerebrospinal fluid, Spinal Cord/*immunology
Subject categories Microbiology in the medical area


We analysed the relationship between cerebrospinal fluid (CSF) concentrations of the light subunit of the neurofilament protein (NFL, a marker of neurons, mainly axons), neopterin (a marker of immune activation), and quantitative HIV RNA levels in 47 patients with HIV-1 infection, 25 of whom had AIDS. In the AIDS patients, the mean levels of CSF NFL were high indicating neuronal destruction. The CSF NFL and the CSF neopterin concentrations were correlated in the subgroup of patients without CNS opportunistic infection (p < 0.05). There was no significant correlation between NFL and HIV RNA levels in CSF. In HIV seropositive patients without AIDS, only 3/22 had CSF NFL concentrations above the upper normal reference value. The results suggest that CNS neuronal destruction occurs frequently in patients with AIDS but rarely in those without AIDS, and that immune activation rather than the HIV viral load is associated with neurochemical signs of axonal destruction.

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