Plasma and cerebrospinal fluid human immunodeficiency virus type-1 (HIV-1)RNA levels in HIV-related cognitive impairment

Cerebrospinal fluid (CSF) and plasma HIV-1 RNA levels were prospectively me asured by the Roche Amplicor Monitor polymerase chain reaction assay in 30 HIV-1 infected patients without central nervous system opportunistic infect ions. All participants completed a global neuropsychological battery consis ting of Mattis Dementia Rating Scale. Additional tests were used to better characterize the type of cognitive changes with a specific reference to fro ntal lobe function. The neuropsychological evaluation confirmed the subcort ical pattern of cognitive dysfunction. CSP and plasma HIV-1 RNA levels were significantly correlated. No correlation was detected with either blood or CSF RNA levels and the global cognitive status, but when stratified in thr ee cognitive subgroups, higher CSP HIV-1 RNA levels were observed in the mo re cognitively impaired subjects. Our results provide further evidence that plasma and CSF HIV-1 RNA level cannot be used as a reliable diagnostic mar ker for HIV-1 associated cognitive disorders. Only longitudinal studies wil l determine whether a high CSF HIV-1 level could be a risk factor for HIV-I dementia. fur J Neurol 6:669-675 (C) 1999 Lippincott Williams & Wilkins.