Increased human immunodeficiency virus (HIV) type 1 DNA content and quinolinic acid concentration in brain tissues from patients with HIV encephalopathy

Sei, S.; Saito, K.; Stewart, S.K.; Crowley, J.S.; Brouwers, P.; Kleiner, D.E.; Katz, D.A.; Pizzo, P.A.; Heyes, M.P.

Journal of Infectious Diseases 172(3): 638-647


ISSN/ISBN: 0022-1899
PMID: 7658054
DOI: 10.1093/infdis/172.3.638
Accession: 008849739

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Levels of human immunodeficiency virus type 1 (HIV-1) DNA and quinolinic acid were examined in areas of the central nervous system (CNS) and lymphoid organs (LN) from 5 AIDS patients with no clinically apparent CNS compromise (group I), 7 with CNS opportunistic diseases (group II), and 8 with HIV encephalopathy (group III). The brains from patients with HIV encephalopathy not only contained higher levels of HIV-1 DNA (cerebrum, P lt .01; cerebellum, P lt .05) as assessed by quantitative polymerase chain reaction but also showed a higher rate of viral pol region mutations suggestive of zidovudine or didanosine resistance than brains from patients in group I or II (P lt .01). CNS quinolinic acid concentrations were significantly higher in group II and III patients than in group I (P = .03), even though quinolinic acid levels in LN were comparable among the 3 groups. These data suggest that CNS inflammatory changes associated with HIV encephalopathy may be triggered by a local productive HIV-1 infection within the CNS.