Cerebrospinal fluid β2-microglobulin in patients with AIDS dementia complex: An expanded series including response to zidovudine treatment

B. J. Brew, R. B. Bhalla, M. Paul, J. J. Sidtis, J. J. Keilp, A. E. Sadler, H. Gallardo, J. C. McArthur, M. K. Schwartz, R. W. Price

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the relationship between cerebrospinal fluid (CSF) β2-microglobulin (β2M) and severity of AIDS dementia complex (ADC), and between CSF β2M and response of ADC to zidovudine. Design: A prospective study. Setting: Tertiary referral hospital. Patients, participants: Seventy-eight patients with varying stages of ADC were selected from a subgroup of a cohort of HIV-seropositive patients who are being studied prospectively for the neurological complications of HIV-1 infection. To enter our study, patients had to have an ADC stage of at least 0.5 (equivocal symptoms or abnormal neurological signs in the absence of functional impairment). A control group of 11 HIV-1-seropositive, neurologically normal patients was chosen randomly from the patients followed in the Multicenter AIDS Cohort Study. Interventions: Patients were assessed neurologically and neuropsychologically and computed tomography of the brain and CSF studies were performed. Main outcome measures: Patients were staged according to severity of ADC on clinical criteria. Neuropsychological test scores were converted to an impairment score. CSF β2M was quantified in both serum and CSF of all patients and in 10 patients with pre- and post-zidovudine asssessments. Results: There was a high correlation between CSF β2M concentration and severity of ADC (P < 0.0001); treatment with zidovudine significantly reduced these concentrations (P = 0.013). CSF β2M concentration was independent of CSF white-cell count and blood-brain barrier impairment. Other CSF changes in the same patients (including blood-brain barrier permeability to albumin, intrathecal synthesis of immunoglobulin G and HIV-1-p24-antigen levels) were less useful as objective correlates of ADC severity and response to zidovudine therapy. Conclusions: CSF β2M may be a valuable marker of ADC severity and response to antiviral therapy.

Original languageEnglish (US)
Pages (from-to)461-465
Number of pages5
JournalAIDS
Volume6
Issue number5
DOIs
StatePublished - 1992

Keywords

  • AIDS
  • Aids dementia complex
  • Dementia
  • HIV-1
  • β-microglobulin

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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