DIAGNOSIS OF HUMAN CYTOMEGALOVIRUS-INFECTION OF THE NERVOUS-SYSTEM BYPP65 DETECTION IN POLYMORPHONUCLEAR LEUKOCYTES OF CEREBROSPINAL-FLUIDFROM AIDS PATIENTS

Detection of human cytomegalovirus (HCMV) pp65 in cerebrospinal fluid (CSF) polymor-phonuclear leukocytes (PMNL) was investigated in 32 CSF samples from 25 AIDS patients with neurologic symptoms. HCMV pp65-posi tive PMNL were detected in 9 CSF samples from 3 patients with polyradi culoneuropathy (frequency, 1.2%-20.8%) and 1 with encephalitis (freque ncy, 56%). pp65-positive PMNL appeared hypersegmented compared with pe ripheral blood PMNL. HCMV was isolated from 3 CSF samples from 2 patie nts with polyradiculoneuropathy. Retrospective quantitation of viral D NA by polymerase chain reaction (PCR) was in agreement with pp65 detec tion in 27 of 28 samples tested (96.4% concordance). Specificity and s ensitivity of pp65 assay versus PCR were 100% (17/17 negative samples) and 90.9% (10/11 positive samples), respectively. Examination of CSF for presence of pp65-positive PMNL appears to be a sensitive and speci fic test for diagnosis of HCMV infections of the nervous system.