Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency syndrome patients.

TLDR

CNS dysfunction is a prominent feature of AIDS, with many patients exhibiting subacute encephalitis consistent with viral infection of the CNS. The authors examined brains from 12 AIDS patients using in situ hybridization to detect HIV nucleic acid sequences and immunocytochemistry to identify viral and cellular proteins. HIV infection was present in nine patients, predominantly affecting white matter and localized mainly to capillary endothelial cells, mononuclear inflammatory cells, and giant cells, with only occasional astrocyte or neuron involvement, indicating that CNS dysfunction is likely due to indirect effects rather than direct neuronal or glial infection.

Abstract

Dysfunction of the central nervous system (CNS) is a prominent feature of the acquired immune deficiency syndrome (AIDS). Many of these patients have a subacute encephalitis consistent with a viral infection of the CNS. We studied the brains of 12 AIDS patients using in situ hybridization to identify human immunodeficiency virus [HIV, referred to by others as human T-cell lymphotropic virus type III (HTLV-III), lymphadenopathy-associated virus (LAV), AIDS-associated retrovirus (ARV)] nucleic acid sequences and immunocytochemistry to identify viral and cellular proteins. Nine patients had significant HIV infection in the CNS. In all examined brains, the white matter was more severely involved than the grey matter. In most cases the infection was restricted to capillary endothelial cells, mononuclear inflammatory cells, and giant cells. In a single case with severe CNS involvement, a low-level infection was seen in some astrocytes and neurons. These results suggest that CNS dysfunction is due to indirect effects rather than neuronal or glial infection.