Document 0609
 DOCN  M95A0609
 TI    Virologic markers of human immunodeficiency virus (HIV) in cerebrospinal
       fluid (CSF) of infected children. American Pediatric Society 104th
       annual meeting and Society for Pediatric Research 63rd annual meeting;
       1994 May 2-5; Seattle.
 DT    9510
 AU    Pratt RD; Nichols S; Dankner WM; Spector SA; University of California,
       San Diego, USA.
 SO    Pediatr AIDS HIV Infect. 1994 Oct;5(5):320 (unnumbered abstract). Unique
       Identifier : AIDSLINE AIDS/95330435
 AB    Central nervous system (CNS) abnormalities and neurocognitive deficits
       often accompany HIV infection in children. In this study, we examined
       CSF of HIV-infected children for the presence of virologic markers. 33
       CSF specimens were obtained from 26 children; 21 from children
       perinatally infected and 5 infected via blood products. Ages at the time
       of the lumbar puncture ranged from 2 days to 13.5 years. Of the 33 CSFs
       cultured for HIV, 16 (48%) were culture(+). The median age for children
       with culture(+) CSF was 4.1 yrs vs 1.8 yrs for culture(-) (p = 0.175).
       Culture(+) CSFs showed higher CSF WBC counts/mm3 compared to culture(-)
       CSFs (mean +/- SD: 5.3 +/- 4.8 vs 2.4 +/- 1.5, respectively, p = 0.029)
       which were predominantly lymphocytic. CSF total protein levels did not
       differ significantly between groups (p = 0.42). Mean age-adjusted CD4+
       lymphocyte counts were 42% of median for children with both culture(+)
       and (-) CSFs. Of 9 children with neurocognitive impairment 6 (67%) were
       CSF culture(+) compared to 2 (25%) of 8 children neurocognitively normal
       (p = 0.11). Abnormal brain CT scans were found in 5 (46%) of 11 of
       CSF(+) vs 5 (42%) of 12 CSF(-). CSF p24 antigen was > or = 20 pg/ml in 3
       children, all of whom were CSF culture(+). Non-syncytium inducing
       phenotype (NSI) occurred in 13 (87%) of 15 isolates while 2 were SI. In
       summary, the detection of infectious virus within CSF correlates with a
       mild lymphocytic pleocytosis; no correlation was observed with age,
       other CSF parameters, CD4 lymphocyte counts, or abnormal brain CT scans.
       These data demonstrate the presence of HIV within the CNS of infected
       children regardless of neurocognitive status, and suggest that
       neurocognitive impairment is dependent on, as yet, unidentified
       host-virus interactions.
 DE    Adolescence  AIDS Dementia Complex/CEREBROSPINAL FLUID/VIROLOGY  Child
       Child, Preschool  CD4 Lymphocyte Count  Human  HIV/*ISOLATION & PURIF
       HIV Infections/*CEREBROSPINAL FLUID/IMMUNOLOGY/VIROLOGY  Infant  Infant,
       Newborn  MEETING ABSTRACT  JOURNAL ARTICLE

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