THE APPLICATION OF THE POLYMERASE-CHAIN-REACTION OF CEREBROSPINAL-FLUID IN THE CLINICAL MANAGEMENT OF AIDS-RELATED CNS DISORDERS

In AIDS patients central nervous system (CNS) illness may be caused by HIV disease itself or by opportunistic agents, resulting in serious m orbidity such as behavioral and motor disturbances, meningitis or ence phalitis, among other disorders. Early diagnosis can allow specific tr eatment (e.g., antimicrobial treatment) that may prevent, ameliorate, or slow the catastrophic sequelae of infection, as well as reduce the need for expensive diagnostic procedures. Conventional microbiology te chniques have proven inadequate for the diagnosis of most AIDS-related CNS diseases. However, the development in the past decade of the appl ication of polymerase chain reaction (PCR) to clinical specimens has f acilitated the early diagnosis of a number of infectious diseases in t hese patients, The technique permits the amplification of target nucle ic acids such that common laboratory methods may then be used for diag nosis. The application of PCR to cerebrospinal fluid for early diagnos is of AIDS-related neurologic complications has been an impressive exa mple of the application of PCR and may form the basis of new algorithm s for diagnosis and possibly the evaluation of treatment protocols.