Assessment of HIV-intrathecal humoral immune response in AIDS-related neurological disorders

Intrathecal synthesis of IgG directed to I-HV antigens was investigated by antibody specific index (ASI), affinity-mediated immunoblot WE) and Western blot (WB) assay in a group of 88 AIDS patients of which 28 with HIV-associ ated neurological disorders (HAND), 13 without associated neurological diso rders (WAND) and 47 with non-HIV-associated neurological disorders (non-HAN D). CD4+ count was above 50 cells/mm(3) (CD4 + > 50) in 30 and below 50/mm( 3) (CD4 + < 50) in 58 patients, respectively, A significantly higher freque ncy for CSF complete anti-gag profile (p < 0.001), and for HIV-specific oli goclonal patterns ("mixed" pattern = p < 0.01) was observed in HAND as comp ared to patterns from the other clinical groups. A decrease in complete ant i-env, anti-pol and anti-gag reactivity was present in CSF of patients with CD4 + < 50 as compared to those with CD4 + > 50. Our findings suggest that AIDS appears to be characterized by an anti-HIV intrathecal humoral immune response which is principally directed to env products with a prevalence o f oligoclonal patterns and CSF complete anti-gag profile in HIV-associated neurological involvement. (C) 2001 Elsevier Science B.V. All rights reserve d.