Document 0825
 DOCN  M9480825
 TI    HIV p24 antigen (Ag) in the CSF using immune complex dissociation (ICD):
       correlation with p24 antibodies (Ab) in CSF, CD4, and cerebral atrophy.
 DT    9410
 AU    Valdez LM; Donovan RM; Mateo NB; Manzor O; Baxa D; Markowitz NP;
       Saravolatz LD; Department of Infectious Diseases, Henry Ford Hospital,
       Detroit,; Michigan.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:622 (abstract no. V-30). Unique
       Identifier : AIDSLINE ASM94/94313120
 AB    The central nervous system is a major target for HIV infection. Studies
       have suggested that p24 Ag in the CSF is associated with the AIDS
       Dementia Complex (ADC). We studied 22 HIV infected patients for the
       presence of p24 Ag and correlated these findings with the presence of
       p24 Ab, cerebral atrophy by CT or MRI, and CD4 count. HIV p24 Ag was
       measured in plasma and CSF with and without ICD (Coulter). CSF p24 Ab
       was determined using western blot (Dupont). ICD detected 5 patients with
       positive p24Ag (22.7%) but only 3 of these patients (13.6%) were
       detected by the free method. Cerebral atrophy was demonstrated in all 5
       patients with CSF p24 Ag, but in only 2 of 17 patients who were CSF p24
       Ag negative (p < 0.001). Western blot detected CSF p24 Ab in 9
       individuals. All the patients with p24 Ab, were p24 Ag negative in their
       CSF (p = 0.056). Only 1 of these 9 showed evidence of cerebral atrophy.
       Neither the presence or the magnitude of plasma p24 Ag (with or without
       ICD) correlated with CSF findings or cerebral atrophy. The mean CD4 in
       patients who had positive CSF p24 Ag was 9 +/- 6.2 cells/microliters,
       compared to 103.9 +/- 165.09 cells/microliters in the patients with a
       negative Ag. In conclusion: 1) ICD increases the sensitivity of p24 Ag
       detection in the CSF. 2) The presence of HIV p24 Ag in the CSF (free or
       ICD) was associated with cerebral atrophy; 71% of those with cerebral
       atrophy had detectable p24 Ag in their CSF. Therefore CSF ICD p24 Ag may
       be of value in the diagnosis of ADC.
 DE    Age Factors  *Antigen-Antibody Complex  Atrophy  AIDS Dementia
       Complex/*CEREBROSPINAL FLUID/*DIAGNOSIS/PATHOLOGY  Brain/*PATHOLOGY
       Comparative Study  Human  HIV Antibodies/*ANALYSIS/BLOOD/*CEREBROSPINAL
       FLUID  HIV Core Protein p24/*CEREBROSPINAL FLUID/IMMUNOLOGY  HIV
       Infections/*CEREBROSPINAL FLUID/PATHOLOGY  Sensitivity and Specificity
       T4 Lymphocytes/*MICROBIOLOGY  MEETING ABSTRACT

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