Soluble CD23 in cerebrospinal fluid: a marker of AIDS-related non-Hodgkin's lymphoma in the brain

Background: AIDS-related non-Hodgkin's lymphoma (NHL) includes systemic lym phomas, often with brain involvement, and primary central nervous system (C NS) lymphomas. Objective: To examine if measurement of soluble CD23 (sCD23) in cerebrospin al fluid (CSF) is useful in the diagnosis and follow-up of AIDS-related NHL . Method: sCD23 was measured by enzyme-linked immunosorbent assay and EBV DNA by nested polymerase chain reaction for a group of 134 patients. The NHL g roup included 14 patients with primary HIV-1 CNS lymphoma, 12 patients with brain involvement of systemic HIV-1 NHL and 10 patients with systemic HIV- 1 NHL without brain involvement. These were compared with HIV-l-infected pa tients with cerebral toxoplasmosis (19), progressive multifocal leukoenceph alitis (PML; 8) and AIDS-related dementia (17) and with asymptomatic HIV-1 carriers (54) and uninfected individuals (50). The levels of sCD23 were com pared with the presence of Epstein-Barr virus (EBV) DNA in CSF. Results: Significantly higher levels of sCD23 were found in the CSF of the patients with brain lymphoma than in those with systemic NHL (P < 0.002) or with cerebral toxoplasmosis, PML and AIDS-related dementia (P < 0.0001). T he sensitivity and specificity of sCD23 in CSF as a marker for detection of brain NHL were 77% and 94%, respectively. High levels of sCD23 were found in CSF from patients with brain NHL independently of the presence (18 out o f 26) or absence (8 out of 26) of EBV DNA. Conclusions: The sCD23 in CSF of HIV-1-infected patients may represent an a dditional, non-invasive marker for diagnosis of brain involvement in AIDS-r elated NH L. (C) 2001 Lippincott Williams & Wilkins.