Cerebral spinal fluid IgG production in HIV-positive patients

A brief characterization of 27 neurologic syndromes occurring in 44 AIDS patients during two years is presented. In 4 out of 7, intrathecal Ig synthesis was demonstrated without the CSF cell count and blood brain barrier values being within a normal range. Ig intrathecal formation was also observed in 2 LAS patients without neurological symptoms. Similar changes in CSF findings occur in other subacute encephalitis, particularly in multiple sclerosis. Activation of CSF B-cells or their depression due to impairment of CD8 T-lymphocytes was indicated as the cause of this phenomenon. In the Authors' opinion this explanation is somewhat general. The possibility of an immune response in CNS was clearly demonstrated, but in the CSF neither B-cells nor Ig producing plasma cells are evident. In addition, it should be noted that the reliability of blood brain barrier and Ig intrathecal assessment procedures is doubtful in ADC disease, because of the severe alterations in serum albumin and Ig concentrations seen in these patients.