INCREASED CEREBROSPINAL-FLUID GANGLIOSIDE GM1 CONCENTRATIONS INDICATING NEURONAL INVOLVEMENT IN ALL STAGES OF HIV-1 INFECTION

Measurements of cerebrospinal fluid (CSF) concentrations of gangliosid es can be used as markers of central nervous system (CNS) neuronal inv olvement. We have analysed the CSF concentrations of the four major br ain gangliosides GM1, GD1a, GD1b, and GT1b at different stages of HIV- 1 infection. CSF samples were collected from 44 HIV-1-infected patient s and from 24 HIV-negative, healthy controls. A significantly higher m ean CSF concentration of the ganglioside GM1 was found in HIV-1-infect ed patients than in HIV-negative controls (27 and 19 nmol/l, respectiv ely, P<0.01). The HIV-infected patients also had a higher mean GM1 pro portion of the total ganglioside concentration (11% compared with 8.5% , P < 0.01). Nine out of 27 patients with asymptomatic HIV-1 infection , three of ten with AIDS without neurological complications, and three of seven with AIDS dementia complex had CSF GM1 concentrations above the mean+2SD in the HIV-negative control group. Conclusion: Biochemica l signs of ongoing neuronal involvement could be found in about one th ird of HIV-1-infected patients. The same frequency was found regardles s of stage, although the highest levels of CSF gangliosides were found in patients with AIDS.