Elsevier

Human Pathology

Volume 22, Issue 7, July 1991, Pages 700-710
Human Pathology

Original contribution
Human immunodeficiency virus-1 infection of the nervous system: An autopsy study of 268 adult, pediatric, and fetal brains

https://doi.org/10.1016/0046-8177(91)90293-XGet rights and content

Abstract

The central nervous system (CNS) of 221 adults and 31 infants or children with the acquired immunodeficiency syndrome (AIDS) was examined with immunocytochemistry for infectious agents and for human immunodeficiency virus-1 (HIV-1) antigen (gp41). Since the major risk factor in this population was intravenous drug abuse, there were more female and pediatric patients than in other neuropathology autopsy series. Although children had a different spectrum of pathologic changes, including less frequent opportunistic infections, women did not differ from men in terms of types or incidence of opportunistic infections, vascular disease, neoplasia, and subacute AIDS encephalitis (SAE). Subacute AIDS encephalitis was detected in 26% of adult and 48% of pediatric brains. Immunocytochemical analysis of 100 adult and 20 pediatric brains revealed gp41 immunoreactivity in 78% and 40%, respectively. Virtually all adult brains with SAE had gp41 immunoreactivity in macrophages and microglia. Even brains with no significant pathology had frequent gp41 immunoreactivity, especially in the basal ganglia. In pediatric brains, including cases with SAE, gp41 immunoreactivity was less abundant, suggesting the possibility of latent infection or viral clearance. Spinal cords with vacuolar myelopathy or corticospinal tract degeneration had only rare gp41-positive cells. Brains from 16 aborted fetuses from HIV-1-seropositive women were all negative for gp41 immunoreactivity, but 12 brains were positive for HIV-1 by the polymerase chain reaction. These results may indicate that HIV-1 infection in fetal brains is below the limits of detection of immunocytochemistry. The differences noted between adults and children suggest that adults more often have productive CNS HIV-1 infection.

References (56)

  • CDC
  • AL Belman et al.

    Neurological complications in infants and children with acquired immune deficiency syndrome

    Ann Neurol

    (1985)
  • AL Belman et al.

    Pediatric acquired immune deficiency syndrome: Neurologic syndromes

    Am J Dis Child

    (1988)
  • DW Dickson et al.

    Central nervous system pathology in pediatric AIDS: An autopsy study

    APMIS

    (1989)
  • PB Kozlowski et al.

    Central nervous system in pediatric HIV infection—A multicenter study

  • SA Fineberg et al.

    Human immunodeficiency virus infection in women: Report of 102 cases

    Mod Pathol

    (1990)
  • K Kure et al.

    Cellular localization of an HIV-1 antigen in subacute AIDS encephalitis using an improved double-labeling immunohistochemical method

    Am J Pathol

    (1990)
  • K Kure et al.

    Morphology and distribution of HIV-1-positive microglia in subacute AIDS encephalitis: Pattern of involvement resembling a multisystem degeneration

    Acta Neuropathol

    (1990)
  • WD Lyman et al.

    HIV-1 infection of human fetal central neryous system tissue

  • WD Lyman et al.

    Detection of HIV in fetal central nervous system tissue

    AIDS

    (1990)
  • WA Michalak et al.

    Immunocytochemical detection of papovavirus in progressive multifocal leukoencephalopathy (PML) with commercially available polyclonal antibody

    Lab Invest

    (1989)
  • RJ Marder et al.

    Immunohistochemical analysis of human lymphomas with monoclonal antibodies to B cell and Ia antigens reactive in paraffin sections

    Lab Invest

    (1985)
  • T Maniatus et al.

    Molecular Cloning: A Laboratory Manual

    (1982)
  • K Kure et al.

    Solitary midbrain toxoplasmosis and olivary hypertrophy in a patient with acquired immunodeficiency syndrome

    Clin Neuropathol

    (1989)
  • KM Weidenheim et al.

    Unusual patterns of H. Capsulatum meningitis and progressive multifocal leukoencephalopathy in an AIDS patient

  • CK Petito et al.

    Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome

    N Engl J Med

    (1985)
  • DS Horoupian et al.

    Acquired immune deficiency syndrome and multiple tract degeneration in a homosexual man

    Ann Neurol

    (1984)
  • JF Llena et al.

    Massive fatal intracerebral hemorrhage: A rare CNS complication of AIDS

    J Neuropathol Exp Neurol

    (1990)
  • Cited by (260)

    • Global developments in HIV neurology

      2018, Handbook of Clinical Neurology
    View all citing articles on Scopus
    View full text