AXONAL DAMAGE REVEALED BY ACCUMULATION OF BETA-APP IN HIV-POSITIVE INDIVIDUALS WITHOUT AIDS

The presence of neuropsychological disturbances in HIV-positive, pre-s ymptomatic individuals is a controversial issue. Neuroimaging studies have not shown brain atrophy or hyperintensity in the white matter, wh ereas proton magnetic resonance spectroscopy has revealed some abnorma lity of cerebral biochemistry. Using an antibody to beta-amyloid precu rsor protein (beta-APP), we previously demonstrated frequent and wides pread axonal changes in the brains of AIDS patients. In this study, we extended the use of beta-APP to asymptomatic patients in order to est ablish a possible morphological correlation with neuropsychological di sorders. Brain samples from 29 patients were examined. Results showed bundles of beta-APP-positive axons in 8/29 cases (27%). The changes, s een in both superficial and deep white matter, were either focal or di ffuse, could not be visualized by silver or ubiquitin stains, and did not coexist with any change in distribution or morphology of astrocyte s and microglial cells. We conclude that in HIV-positive asymptomatic individuals, axonal changes: (a) may be related to the state of immune activation with consequent presence of toxic substances, including cy tokines, observed in these patients; (b) may represent mild changes th at could undergo repair, unless other pathological events, such as the supervening of the AIDS stage and the specific encephalitis, make the m permanent.