Je. Bell et al., HUMAN-IMMUNODEFICIENCY-VIRUS AND THE BRAIN - INVESTIGATION OF VIRUS LOAD AND NEUROPATHOLOGIC CHANGES IN PRE-AIDS SUBJECTS, The Journal of infectious diseases, 168(4), 1993, pp. 818-824
Brain tissue was examined for evidence of human immunodeficiency virus
(HIV) infection in 23 intravenous drug users who died suddenly some y
ears after seroconversion but while still in presymptomatic stages of
infection. None showed giant cell encephalitis, but 14 showed T cell l
ymphocytic leptomeningitis and 3 showed other significant neuropatholo
gic features. Quantitative polymerase chain reaction for HIV was appli
ed to 13 of the 23 with negative results in 6 and very low positive re
sults in the other 7, a finding consistent with contamination by resid
ual infected blood in the brain tissue. This contrasted with findings
in AIDS-infected tissue, in which substantial amounts of provirus were
found. It is concluded that significant infection in brain tissue doe
s not occur in presymptomatic stages of HIV infection and that invasio
n of the central nervous system may be delayed until the transition to
symptomatic AIDS.