Summary
The HIV-1 RNA in plasma and CSF samples from 40 HIV-1 infected patients was measured by a polymerase chain reaction (PCR) technique. The possible implication of cytokines in HIV-1 replication was investigated by measuring the concentrations of tumor necrosis factor α (TNF-α), macrophage colony stimulation factor (M-CSF) and interleukin-6 (IL-6) in these fluids. HIV-1 RNA was quantified in all plasma samples and in 87.5% of the CSF samples. CSF HIV-1 RNA titers did not correlate with the stage of disease or the CD4+ T cell counts, unlike the plasma HIV-1 RNA titers. These results were confirmed when patients with a blood brain barrier damage, as assessed by the CSF/plasma albumin ratio, were excluded from the analysis. TNF-α levels were statistically correlated with the HIV-1 RNA in plasma and CSF. These data demonstrate that HIV-1 replication in the CSF at each clinical stage can be accurately measured with PCR and, although the titers of HIV-1 RNA copies in the CSF are correlated with those in the plasma, the magnitude of HIV-1 replication in CSF is not directly linked to the stage of disease, or to the CD4+ T cell count. The significance of early high levels of HIV-1 RNA in CSF is now being studied prospectively.
Zusammenfassung
HIV-1-RNA wurde mittels Polymerasekettenreaktion (PCR) in Plasma- und Liquorproben von 40 HIV-1-infizierten Patienten quantifiziert. Um mögliche Einflüsse durch Zytokine auf die HIV-1-Replikation zu erfassen, wurden Tumornekrosefaktor-α (TNF-α), Makrophagen-Kolonie-stimulierender Faktor (M-CSF) und Interleukin-6 (IL-6) in diesen Flüssigkeiten ebenfalls bestimmt. Eine Quantifizierung von HIV-1 RNA war in allen Plasmaproben und in 87,5% der Liquorproben möglich. Im Gegensatz zu den HIV-1-RNA-Titern im Plasma fand sich zwischen HIV-1-RNA-Titern im Liquor und dem Krankheitsstadium oder den CD4+-T-Zell-Zahlen keine Korrelation. Diese Ergebnisse bestätigten sich auch bei Patienten, bei denen gemessen am Liquor-Ausschluß von Plasma-Albumin-Quotienten eine Blut-Liquor-Schrankenstörung bestand. Die HIV-1-Replikation kann in allen klinischen Stadien mittels PCR exakt quantifiziert werden. Obwohl die Liquor-Titer an HIV-1-RNA-Kopien mit den Plasmatitern korrelieren, besteht dennoch keine direkte Beziehung zum Krankheitsstadium oder zur CD4+-Zellzahl. In einer prospektiven Studie wird derzeit die Bedeutung frühzeitig auftretender HIV-1-RNA-Spiegel im Liquor untersucht.
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Lafeuillade, A., Pellegrino, P., Poggi, C. et al. HIV-1 replication in the plasma and cerebrospinal fluid. Infection 24, 367–371 (1996). https://doi.org/10.1007/BF01716081
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DOI: https://doi.org/10.1007/BF01716081