CEREBROSPINAL-FLUID ANALYSIS IN HIV-1-INFECTED CHILDREN - IMMUNOLOGICAL AND VIROLOGICAL FINDINGS BEFORE AND AFTER AZT THERAPY

Immunological and viral studies were conducted on cerebrospinal fluid from 31 HIV-l-infected children, of whom 23 were neurologically asympt omatic and 8 had progressive encephalopathy. After AZT treatment, a se cond cerebrospinal fluid specimen was obtained from 15 children, 11 of whom were neurologically asymptomatic and 4 had progressive encephalo pathy. Virus isolation and p24Ag detection were more frequent in child ren with progressive encephalopathy than in asymptomatic children (66% versus 12%) and were inversely correlated with intrathecal HIV-l-anti body detection (anti-gag AB: 25% versus 70%). High concentrations of i nterleukin-1 beta (IL-1 beta) and IL-6 were found in children with pro gressive encephalopathy (50% and 37%, respectively), but low levels we re also detected in some asymptomatic children (13% and 9%, respective ly). Tumour necrosis factor-a (TNF alpha) was not found. AZT treatment induced disappearance of p24Ag in cerebrospinal fluid, as well as a m arked reduction in cytokine levels. Cytokine determination may be usef ul in monitoring AZT treatment in children with progressive encephalop athy.