INTRATHECAL REACTIVITY FOR MYELIN COMPONENTS PRECEDES DEVELOPMENT OF NEUROLOGICAL SYMPTOMS IN AIDS PATIENTS

The central nervous system is considered an early and common target fo r the human immunodeficiency virus type 1 (HIV-1). Serum and cerebrosp inal fluid (CSF) from 20 HIV positive patients, including 14 with AIDS -dementia complex (CDC stage IV) and 6 asymptomatic individuals (CDC s tage II) were analyzed by enzyme immunoassay for detection of antibodi es to native myelin basic protein (MBP) and for the aminoacid sequence 68-84 exposed after partial degradation of native MBP. Control groups included HIV-1 negative patients with degenerative and/or vascular de mentia, chronic multiple sclerosis (MS) and individuals without any si gn of neurological or cognitive disturbances. As opposed to control gr oups, serum and CSF samples from MS and HIV-1 infected patients showed several oligoclonal bands running in the gamma region. AIDS-dementia complete (ADC) patients had increasingly high intrathecal IgG specific antibody titers for the aminoacid sequence 68-84 of MBP. Marked intra thecal antibody production for myelin components was also detected in the majority of HIV-1 infected asymptomatic individuals. Such alterati on paralleled development of cognitive deficits, neurological abnormal ities and appearance of CNS demyelinating plaques. Preferential immune recognition of this myelin epitope within the CSF during early stages of HIV-1 infection might point to an ongoing process of active demyel ination and ultimately indicate subclinical CNS involvement.