PROLACTIN LEVELS IN THE CEREBROSPINAL-FLUID OF PATIENTS WITH HIV-INFECTION AND AIDS

The objective of this study was to assess the levels of prolactin (PRL ) in cerebrospinal fluid (CSF) of HIV-infected patients with regard to nonHIV-infected patients, and to assess the levels of prolactin in th e CSF of HIV-infected patients with and without neurological HIV-invol vement Seventeen HIV-infected patients with different degrees of immun ological and neurological involvement were studied. A second group of six HIV-seronegative patients with varying clinical conditions requiri ng lumbar punctures were included as controls. CSF was collected from patients and controls. Patients were studied neurologically and neurop sychologically, and computed tomography of the brain were performed. T hey were staged according to CDC clinical classification for HIV infec tion, and on the basis of tomographic findings into one of five stages . An additional classification for neurological involvement in AIDS wa s used CD4(+) cell counts, CSF studies, serum-prolactin levels and CSF -prolactin levels were performed as principal laboratory tests. CSF PR L concentrations were significantly higher in the HIV-infected group ( n = 17) than the nonHIV infected control group (n=6) (mean+/-s.d.; 5.7 7+/-2.22 vs. 3.53+/-0.69x10(-6)gl(-1), respectively; p = 0.009, Mann-W hitney U-test). Moreover, even CSF-PRL concentration was higher in HIV -infected patients without cognitive impairment (stage 0 of the clinic al classification), (n = 12) in comparison with nonHIV infected contro ls (n=6) (mean+/-s.d.; 5.51+/-2.31 vs. 3.53+/-0.69x10(-1) gl(-1), resp ectively; p = 0.028, Mann-Whitney U-test). There was a good correlatio n between serum and CSF-PRL levels in HIV-infected patients when measu red by the Spearman Rank Test (r(s), = 0.773; p = 0.005). PRL raised s erum levels were found in 4 out of 13 patients (30.73%). We conclude t hat higher levels of CSF-PRL are more frequently found in HIV-infected patients in comparison to uninfected controls. High levels of circula ting PRL were also found in HIV-infected patients corroborating result s from other work. A good correlation coefficient was found between ci rculating and CSF-PRL levels in HIV-infected patients, suggesting that disruption of the blood-brain barrier might account for a possible pa thogenic mechanism.