Measurement of CNS HIV burden and its association with neurologic damage

AIDS dementia complex affects between 20 and 30% of terminally ill AIDS patients. The histopathologic substrate of this clinical syndrome is chronic HIV infection of the nervous system termed HIV encephalitis. We hypothesize that the abundance and length of time that HIV is present in the CNS determines the severity of neurologic damage. We compared three different methods of assessing HIV burden in the CNS. While the assays vary in sensitivity, each provides a quantitative estimate of viral burden that can be compared between laboratories. Assays of provirus were readily divided into two groups, while protein assays showed a wider range. HIV-mediated neurotoxicity might be expected to more closely depend upon productive infection.