Document 0012
 DOCN  M9480012
 TI    Cerebrospinal fluid human immunodeficiency virus type 1 (HIV-1) p24
       antigen levels in HIV-1-related dementia.
 DT    9410
 AU    Royal W 3rd; Selnes OA; Concha M; Nance-Sproson TE; McArthur JC;
       Department of Neurology, Johns Hopkins University School of; Medicine,
       Baltimore, MD.
 SO    Ann Neurol. 1994 Jul;36(1):32-9. Unique Identifier : AIDSLINE
       MED/94296064
 AB    Human immunodeficiency virus type 1 (HIV-1) p24 antigen, a putative
       marker of virus load, was assayed in 79 blood and 83 cerebrospinal fluid
       (CSF) samples from 90 HIV-1-seropositive individuals with or without
       dementia. Twenty-eight subjects had no evidence of neuropsychological
       impairment, 17 had mild impairment without objective evidence of
       dementia, and 45 were demented. HIV-1 p24 antigen was detected more
       frequently in CSF samples from demented (19/40) than normal (1/26) or
       mildly impaired (1/17) subjects and in 67% of individuals with
       significant dementia (MSK stages 2-4). p24 Antigen was detected less
       frequently in CSF from demented subjects on antiretroviral drugs than
       untreated demented individuals. Overall, the sensitivity of the antigen
       capture assay in CSF among demented individuals was 47.5%; the
       specificity, 95.0%; positive predictive value, 90.4%; negative
       predictive value, 66.1%; and the efficiency, 72.2%. A direct
       relationship was also noted between the degree of cognitive impairment
       and blood p24 antigen detection frequency and antigen concentration.
       CD4+ blood lymphocyte counts were lower for demented individuals, and
       HIV-1 p24 antigen was detected more frequently and p24 antigen
       concentration was higher in blood and CSF from individuals with low CD4+
       blood lymphocyte counts. beta 2-Microglobulin levels were higher in CSF
       from demented subjects and correlated directly with CSF p24 antigen
       concentration. However, in contrast to CD4+ blood lymphocyte counts and
       beta 2-microglobulin levels, only p24 antigen concentration correlated
       with dementia severity. Therefore, p24 antigen can be a useful marker
       for dementia related to HIV-1 infection.
 DE    beta 2-Microglobulin/ANALYSIS  Adult  AIDS Dementia
       Complex/BLOOD/*CEREBROSPINAL FLUID/DIAGNOSIS  Female  Human  HIV Core
       Protein p24/BLOOD/*CEREBROSPINAL FLUID/IMMUNOLOGY  HIV
       Seropositivity/BLOOD/CEREBROSPINAL FLUID/DIAGNOSIS  Leukocyte Count
       Male  Prognosis  Severity of Illness Index  Support, U.S. Gov't, P.H.S.
       T4 Lymphocytes/IMMUNOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).