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Cerebrospinal fluid analysis in human immunodeficiency virus infection

C D Hall1, C R Snyder, K R Robertson

  • 1Department of Neurology, University of North Carolina, Chapel Hill 27599-7025.

Annals of Clinical and Laboratory Science
|May 1, 1992
PubMed

Insights

Cerebrospinal fluid (CSF) analysis in HIV+ individuals revealed frequent abnormalities that may mimic infections. These changes, particularly oligoclonal bands and altered albumin/IgG ratios, correlate with CD4+ counts but not necessarily with neurological disease.

Area of Science:

  • Neuroscience
  • Immunology
  • Infectious Diseases

Background:

  • Human immunodeficiency virus (HIV) infection can affect the central nervous system.
  • Assessing neurological involvement in HIV+ individuals often involves cerebrospinal fluid (CSF) analysis.
  • Interpreting CSF findings in HIV+ patients requires understanding potential confounding factors.

Purpose of the Study:

  • To evaluate cerebrospinal fluid (CSF) analytes in human immunodeficiency virus (HIV+) individuals.
  • To assess the relationship between CSF abnormalities and neurological involvement or disease staging.
  • To identify potential misinterpretations of CSF results in HIV+ patients.

Main Methods:

  • Analysis of CSF samples from 59 HIV+ individuals.
  • Measurement of glucose, total protein, cell counts, p24 antigen, CSF:serum albumin/IgG ratios, and oligoclonal bands.
  • Correlation of CSF analyte abnormalities with CD4+ lymphocyte counts and HIV disease staging.

Main Results:

  • Eighty percent of CSF samples exhibited one or more abnormalities.
  • CSF oligoclonal banding (31%) and disturbed CSF:serum albumin/IgG ratios (30%) correlated with decreased CD4+ counts.
  • Disturbances in CSF:serum albumin/IgG ratios also related to non-neurological HIV disease severity.
  • No significant relationship found between CSF abnormalities and the presence of diagnosed neurological disease.

Conclusions:

  • CSF abnormalities are common in HIV+ individuals and can mimic opportunistic infections.
  • Oligoclonal bands and altered CSF:serum albumin/IgG ratios are linked to immune status (CD4+ count) and disease stage.
  • CSF findings may lead to artifactually elevated enzyme levels, potentially causing erroneous clinical decisions.
  • The presence of neurological disease in HIV+ patients was not significantly correlated with the observed CSF abnormalities, highlighting the need for cautious interpretation.

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