ELEVATED CEREBROSPINAL-FLUID SULFATIDE CONCENTRATIONS AS A SIGN OF INCREASED METABOLIC TURNOVER OF MYELIN IN HIV TYPE-I INFECTION

Cerebrospinal fluid (CSF) sulfatide concentrations were analyzed in 18 patients with asymptomatic HIV-1 infection, in 16 patients with AIDS who were free from opportunistic infections in the central nervous sys tem (CNS), in 12 HIV-l-infected patients with opportunistic CNS infect ions or lymphoma, and in 19 HIV-negative controls, by thin-layer chrom atography overlay technique using an antisulfatide antibody to estimat e the metabolic turnover of myelin, The majority of asymptomatic HIV-1 -infected patients had normal CSF sulfatide concentrations, but the me an CSF sulfatide concentration was still elevated compared to that in HIV-negative controls (152 compared to 99 nmol/liter, p < 0.05), The C SF sulfatide concentrations in the AIDS group (mean 395 nmol/liter) we re significantly increased compared to those in asymptomatic HIV-l-inf ected patients (p < 0.01) and in HIV-negative controls (p < 0.001), bu t did not differ significantly between patients with and without demen tia, Increased CSF sulfatide concentrations were also found in patient s with opportunistic infection or lymphoma in the CNS. In the entire s tudy population, the sulfatide levels were associated with blood-brain barrier function, but not with intrathecal immunoglobulin production or with positive HIV isolations from CSF, Thus, signs of white matter changes, measured as increased CSF sulfatide concentrations, could be found in some asymptomatic HIV-l-infected patients, but the highest le vels were seen in patients with AIDS.