HIV-1 REPLICATION IN THE PLASMA AND CEREBROSPINAL-FLUID

The HIV-1 RNA in plasma and CSF samples from 40 HIV-1 infected patient s was measured by a polymerase chain reaction (PCR) technique. The pos sible implication of cytokines in HIV-1 replication was investigated b y measuring the concentrations of tumor necrosis factor alpha (TNF-alp ha), macrophage colony stimulation factor (M-CSF) and interleukin-6 (I L-6) in these fluids. HIV-1 RNA was quantified in all plasma samples a nd in 87.5% of the CSF samples. CSF HIV-1 RNA titers did not correlate with the stage of disease or the CD4(+) T cell counts, unlike the pla sma HIV-1 RNA titers. These results were confirmed when patients with a blood brain barrier damage, as assessed by the CSF/plasma albumin ra tio, were excluded from the analysis, TNF-a levels were statistically correlated with the HIV-1 RNA in plasma and CSF. These data demonstrat e that HIV-1 replication in the CSF at each clinical stage can be accu rately measured with PCR and, although the titers of HIV-1 RNA copies in the CSF are correlated with those in the plasma, the magnitude of H IV-1 replication in CSF is not directly linked to the stage of disease , or to the CD4(+) T cell count. The significance of early high levels of HIV-1 RNA in CSF is now being studied prospectively.