Chapter 13 : Cerebrospinal Fluid Markers in the Management of Central Nervous System HIV Infection and the AIDS Dementia Complex

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Cerebrospinal Fluid Markers in the Management of Central Nervous System HIV Infection and the AIDS Dementia Complex, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815691/9781555813697_Chap13-1.gif /docserver/preview/fulltext/10.1128/9781555815691/9781555813697_Chap13-2.gif


The major clinical and pathological features of the AIDS dementia complex (ADC), or synonymously, AIDS dementia, HIV-associated dementia, and minor cognitive motor disorder, were characterized almost 20 years ago. The fundamental difficulty is that although ADC is caused by HIV itself, the presence of HIV in cerebrospinal fluid (CSF) has little diagnostic specificity. The authors describe a pathogenetically based approach using a combination of CSF markers. In simple terms, ADC pathogenesis can be considered to result from the evolving interactions of three factors: the driving force, HIV; the modulating influence, immune dys-regulation; and the target, central nervous system (CNS). Importantly, alteration of the immune system is likely important in permitting progressive HIV infection of the CNS and in determining its pathogenic character. In the immunological marker category, the most promising measurements are those of CSF neopterin and monocyte chemotactic protein 1 (MCP-1). The uncertainty of ADC diagnosis more than 20 years after its initial characterization remains a conspicuous shortcoming both in the clinic and in clinical trials. There is still a pressing need to develop objective, laboratory-based markers to aid in predicting development of ADC, establishing ADC diagnosis, and appraising disease activity, including treatment responses. While it is likely that the foundation has been laid with a number of exploratory studies already published, these have fallen short of practical clinical application.

Citation: Gisslén M, Hagberg L, Cinque P, Brew B, Price R. 2009. Cerebrospinal Fluid Markers in the Management of Central Nervous System HIV Infection and the AIDS Dementia Complex, p 173-179. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch13

Key Concept Ranking

AIDS Dementia Complex
Magnetic Resonance Imaging
Progressive Multifocal Leukoencephalopathy
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

The three principal components of HIV-1-related neurodegeneration and ADC.

Citation: Gisslén M, Hagberg L, Cinque P, Brew B, Price R. 2009. Cerebrospinal Fluid Markers in the Management of Central Nervous System HIV Infection and the AIDS Dementia Complex, p 173-179. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Abdulle, S.,, L. Hagberg,, B. Svennerholm,, D. Fuchs, and, M. Gisslen. 2002. Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection. AIDS 16: 21452149.
2. Abdulle, S.,, L. Hagberg, and, M. Gisslen. 2005. Effects of antiretroviral treatment on blood-brain barrier integrity and intrathecal immunoglobulin production in neuroasymptomatic HIV-1-infected patients. HIV Med. 6: 164169.
3. Ammassari, A.,, A. Cingolani,, P. Pezzotti,, D. De Luca,, R. Murri,, M. Giancola,, L. Larocca, and, A. Antinori. 2000. AIDS-related focal brain lesions in the era of highly active antiretroviral therapy. Neurology 55: 11941200.
4. Andersson, L.,, P. Fredman,, A. Lekman,, L. Rosengren, and, M. Gisslen. 1998. Increased cerebrospinal fluid ganglioside GD3 concentrations as a marker of microglial activation in HIV type 1 infection. AIDS Res. Hum. Retrovir. 14: 10651069.
5. Andersson, L.,, L. Hagberg,, D. Fuchs,, B. Svennerholm, and, M. Gisslen. 2001. Increased blood-brain barrier permeability in neuro-asymptomatic HIV-1-infected individuals-correlation with cerebrospinal fluid HIV-1 RNA and neopterin levels. J. Neurovirol. 7: 542547.
6. Berger, J.,, M. Kumar,, A. Kumar,, J. Fernandez, and, B. Levin. 1994. Cerebrospinal fluid dopamine in HIV-1 infection. AIDS 8: 6771.
7. Bernasconi, S.,, P. Cinque,, G. Peri,, S. Sozzani,, A. Crociati,, W. Torri,, E. Vicenzi,, L. Vago,, A. Lazzarin,, G. Poli, and, A. Mantovani. 1996. Selective elevation of monocyte chemotactic protein-1 in the cerebrospinal fluid of AIDS patients with cytomegalovirus encephalitis. J. Infect. Dis. 174: 10981101.
8. Bossi, P.,, N. Dupin,, A. Coutellier,, F. Bricaire,, C. Lubetzki,, C. Katlama, and, V. Calvez. 1998. The level of human immunodeficiency virus (HIV) type 1 RNA in cerebrospinal fluid as a marker of HIV encephalitis. Clin. Infect. Dis. 26: 10721073.
9. Brew, B.,, R. Bhalla,, M. Paul,, H. Gallardo,, J. McArthur,, M. Schwartz, and, R. Price. 1990. Cerebrospinal fluid neopterin in human immunodeficiency virus type 1 infection. Ann. Neurol. 28: 556560.
10. Brew, B.,, R. Bhalla,, M. Paul,, J. Sidtis,, J. Keilp,, A. Sadler,, H. Gallardo,, J. McArthur,, M. Schwartz, and, R. Price. 1992. Cerebrospinal fluid beta 2-microglobulin in patients with AIDS dementia complex: an expanded series including response to zidovudine treatment. AIDS 6: 461465.
11. Brew, B.,, L. Pemberton,, P. Cunningham, and, M. Law. 1997a. Levels of human immunodeficiency virus type 1 RNA in cerebrospinal fluid correlate with AIDS dementia stage. J. Infect. Dis. 175: 963966.
12. Brew, B.,, L. Pemberton,, P. Cunningham, and, M. Law. 1997b. Levels of human immunodeficiency virus type 1 RNA in cerebrospinal fluid correlate with AIDS dementia stage. J. Infect. Dis. 175: 963966.
13. Brew, B.,, L. Pemberton,, K. Blennow,, A. Wallin, and, L. Hagberg. 2005. CSF amyloid beta42 and tau levels correlate with AIDS dementia complex. Neurology 65: 14901492.
14. Chiodi, F.,, A. Valentin,, B. Keys,, S. Schwartz,, B. Asjo,, S. Gartner,, M. Popovic,, J. Albert,, V. Sundqvist, and, E. Fenyo. 1989. Biological characterization of paired human immunodeficiency virus type 1 isolates from blood and cerebrospinal fluid. Virology 173: 178187.
15. Cinque, P.,, B. J. Brew,, M. Gisslén,, L. Hagberg, and, R. W. Price. 2007. Cerebrospinal fluid markers in central nervous system HIV infection and AIDS dementia complex, p. 261–300. In P. Portegies and, J. Berger (ed.), Handbook of Clinical Neurology: AIDS and HIV Dementias, 3rd series, vol. 85. Elsevier.
16. Cinque, P.,, G. Cleator,, T. Weber,, P. Monteyne,, C. Sindic,, G. Gerna,, A. van Loon, and, P. Klapper. 1998a. Diagnosis and clinical management of neurological disorders caused by cytomegalovirus in AIDS patients. European Union Concerted Action on Virus Meningitis and Encephalitis. J. Neurovirol. 4: 120132.
17. Cinque, P.,, M. Nebuloni,, M. Santovito,, R. Price,, M. Gisslen,, L. Hagberg,, A. Bestetti,, G. Vago,, A. Lazzarin,, F. Blasi, and, N. Sidenius. 2004. The urokinase receptor is overexpressed in the AIDS dementia complex and other neurological manifestations. Ann. Neurol. 55: 687694.
18. Cinque, P.,, P. Scarpellini,, L. Vago,, A. Linde, and, A. Lazzarin. 1997. Diagnosis of central nervous system complications in HIV-infected patients: cerebrospinal fluid analysis by the polymerase chain reaction. AIDS 11: 117.
19. Cinque, P.,, L. Vago,, D. Ceresa,, F. Mainini,, M. Terreni,, A. Vagani,, W. Torri,, S. Bossolasco, and, A. Lazzarin. 1998b. Cerebrospinal fluid HIV-1 RNA levels: correlation with HIV encephalitis. AIDS 12: 389394.
20. Coakley, E.,, C. Petropoulos, and, J. Whitcomb. 2005. Assessing chemokine co-receptor usage in HIV. Curr. Opin. Infect. Dis. 18: 915.
21. Conant, K.,, A. Garzino-Demo,, A. Nath,, J. McArthur,, W. Halliday,, C. Power,, R. Gallo,, and E. Major. 1998. Induction of monocyte chemoattractant protein-1 in HIV-1 Tat-stimulated astrocytes and elevation in AIDS dementia. Proc. Natl. Acad. Sci. USA 95: 31173121.
22. Conant, K.,, J. McArthur,, D. Griffin,, L. Sjulson,, L. Wahl, and, D. Irani. 1999. Cerebrospinal fluid levels of MMP-2, 7, and 9 are elevated in association with human immunodeficiency virus dementia. Ann. Neurol. 46: 391398.
23. Cunningham, P.,, D. Smith,, C. Satchell,, D. Cooper, and, B. Brew. 2000. Evidence for independent development of resistance to HIV-1 reverse transcriptase inhibitors in the cerebrospinal fluid. AIDS 14: 19491954.
24. d’Arminio Monforte, A.,, P. Cinque,, A. Mocroft,, F. Goebel,, F. Antunes,, C. Katlama,, U. Justesen,, S. Vella,, O. Kirk, and, J. Lundgren. 2004. Changing incidence of central nervous system diseases in the EuroSIDA cohort. Ann. Neurol. 55: 320328.
25. Di Stefano, M.,, F. Sabri,, T. Leitner,, B. Svennerholm,, L. Hagberg,, G. Norkrans, and, F. Chiodi. 1995. Reverse transcriptase sequence of paired isolates of cerebrospinal fluid and blood from patients infected with human immunodeficiency virus type 1 during zidovudine treatment. J. Clin. Microbiol. 33: 352355.
26. Eggers, C.,, K. Hertogs,, H. Sturenburg,, J. van Lunzen, and, H. Stellbrink. 2003. Delayed central nervous system virus suppression during highly active antiretroviral therapy is associated with HIV encephalopathy, but not with viral drug resistance or poor central nervous system drug penetration. AIDS 17: 18971906.
27. Ellis, R.,, K. Hsia,, S. Spector,, J. Nelson,, R. Heaton,, M. Wallace,, I. Abramson,, J. Atkinson,, I. Grant,, J. McCutchan, et al. 1997. Cerebrospinal fluid human immunodeficiency virus type 1 RNA levels are elevated in neurocognitively impaired individuals with acquired immunodeficiency syndrome. Ann. Neurol. 42: 679688.
28. Fuchs, D.,, F. Chiodi,, J. Albert,, B. Asjo,, L. Hagberg,, A. Hausen,, G. Norkrans,, G. Reibnegger,, E. Werner, and, H. Wachter. 1989. Neopterin concentrations in cerebrospinal fluid and serum of individuals infected with HIV-1. AIDS 3: 285288.
29. Gendelman, H.,, I. Grant,, I. Everall,, S. Lipton, and, S. Swindells. 2005. The Neurology of AIDS. Oxford University Press, Oxford, United Kingdom.
30. Gisslen, M.,, P. Fredman,, G. Norkrans, and, L. Hagberg. 1996. Elevated cerebrospinal fluid sulfatide concentrations as a sign of increased metabolic turnover of myelin in HIV type I infection. AIDS Res. Hum. Retrovir. 12: 149155.
31. Gisslen, M.,, D. Fuchs,, B. Svennerholm, and, L. Hagberg. 1999. Cerebrospinal fluid viral load, intrathecal immunoactivation, and cerebrospinal fluid monocytic cell count in HIV-1 infection. J. Acquir. Immune Defic. Syndr. 21: 271276.
32. Gisslen, M.,, L. Hagberg,, D. Fuchs,, G. Norkrans, and, B. Svennerholm. 1998. Cerebrospinal fluid viral load in HIV-1-infected patients without antiretroviral treatment: a longitudinal study. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 17: 291295.
33. Gisslen, M.,, L. Rosengren,, L. Hagberg,, S. Deeks, and, R. Price. 2005. Cerebrospinal fluid signs of neuronal damage after antiretroviral treatment interruption in HIV-1 infection. AIDS Res. Ther. 2: 6.
34. Gonzalez-Scarano, F.,, and G. Baltuch. 1999. Microglia as mediators of inflammatory and degenerative diseases. Annu. Rev. Neurosci. 22: 219240.
35. Gonzalez-Scarano, F.,, and J. Martin-Garcia. 2005. The neuropathogenesis of AIDS. Nat. Rev. Immunol. 5: 6981.
36. Green, A.,, G. Giovannoni,, M. Hall-Craggs,, E. Thompson, and, R. Miller. 2000. Cerebrospinal fluid tau concentrations in HIV infected patients with suspected neurological disease. Sex. Transm. Infect. 76: 443446.
37. Griffin, D.,, J. McArthur, and, D. Cornblath. 1990. Soluble interleukin-2 receptor and soluble CD8 in serum and cerebrospinal fluid during human immunodeficiency virus-associated neurologic disease. J. Neuroimmunol. 28: 97109.
38. Griffin, D.,, J. McArthur, and, D. Cornblath. 1991. Neopterin and interferon-gamma in serum and cerebrospinal fluid of patients with HIV-associated neurologic disease. Neurology 41: 6974.
39. Griffin, D.,, S. Wesselingh, and, J. McArthur. 1994. Elevated central nervous system prostaglandins in human immunodeficiency virus-associated dementia. Ann. Neurol. 35: 592597.
40. Hagberg, L.,, L. Dotevall,, G. Norkrans,, M. Larsson,, H. Wachter, and, D. Fuchs. 1993. Cerebrospinal fluid neopterin concentrations in central nervous system infection. J. Infect. Dis. 168: 1285- 1288.
41. Hagberg, L.,, D. Fuchs,, L. Rosengren, and, M. Gisslen. 2000. Intrathecal immune activation is associated with cerebrospinal fluid markers of neuronal destruction in AIDS patients. J. Neuroimmunol. 102: 5155.
42. Harrington, P.,, D. Haas,, K. Ritola, and, R. Swanstrom. 2005. Compartmentalized human immunodeficiency virus type 1 present in cerebrospinal fluid is produced by short-lived cells. J. Virol. 79: 79597966.
43. Haughey, N.,, R. Cutler,, A. Tamara,, J. McArthur,, D. Vargas,, C. Pardo,, J. Turchan,, A. Nath, and, M. Mattson. 2004. Perturbation of sphingolipid metabolism and ceramide production in HIV-dementia. Ann. Neurol. 55: 257267.
44. Havlir, D.,, R. Bassett,, D. Levitan,, P. Gilbert,, P. Tebas,, A. Collier,, M. Hirsch,, C. Ignacio,, J. Condra,, H. Gunthard,, D. Richman, and, J. Wong. 2001. Prevalence and predictive value of intermittent viremia with combination HIV therapy. JAMA 286: 171179.
45. Heyes, M.,, B. Brew,, A. Martin,, R. Price,, A. Salazar,, J. Sidtis,, J. Yergey,, M. Mouradian,, A. Sadler,, J. Keilp,, D. Rubinow, and, S. Markey. 1991. Quinolinic acid in cerebrospinal fluid and serum in HIV-1 infection: relationship to clinical and neurological status. Ann. Neurol. 29: 202209.
46. Heyes, M. P.,, K. Saito,, J. S. Crowley,, L. E. Davis,, M. A. Demitrack,, M. Der,, L. A. Dilling,, J. Elia,, M. J. Kruesi,, A. Lackner, et al. 1992. Quinolinic acid and kynurenine pathway metabolism in inflammatory and non-inflammatory neurological disease. Brain 115 (Pt. 5) : 12491273.
47. Kelder, W.,, J. McArthur,, T. Nance-Sproson,, D. McClernon, and, D. Griffin. 1998. Beta-chemokines MCP-1 and RANTES are selectively increased in cerebrospinal fluid of patients with human immunodeficiency virus-associated dementia. Ann. Neurol. 44: 831835.
48. Kolb, S. A.,, B. Sporer,, F. Lahrtz,, U. Koedel,, H. W. Pfister, and, A. Fontana. 1999. Identification of a T cell chemotactic factor in the cerebrospinal fluid of HIV-1-infected individuals as interferon-gamma inducible protein 10. J. Neuroimmunol. 93: 172181.
49. Korber, B.,, K. Kunstman,, B. Patterson,, M. Furtado,, M. McEvilly,, R. Levy, and, S. Wolinsky. 1994. Genetic differences between blood- and brain-derived viral sequences from human immunodeficiency virus type 1-infected patients: evidence of conserved elements in the V3 region of the envelope protein of brain-derived sequences. J. Virol. 68: 74677481.
50. Lanier, E.,, G. Sturge,, D. McClernon,, S. Brown,, M. Halman,, N. Sacktor,, J. McArthur,, J. Atkinson,, D. Clifford,, R. Price,, D. Simpson,, G. Torres,, J. Catalan,, K. Marder,, C. Power,, C. Hall,, C. Romero, and, B. Brew. 2001. HIV-1 reverse transcriptase sequence in plasma and cerebrospinal fluid of patients with AIDS dementia complex treated with Abacavir. AIDS 15: 747751.
51. Lazzarin, A.,, A. Castagna,, G. Cavalli,, M. Amprimo,, M. Vaj,, C. Parravicini,, G. Costanzi,, P. Ronchi,, C. Foppa,, M. Moroni, and, R. Turconi. 1992. Cerebrospinal fluid beta 2-microglobulin in AIDS related central nervous system involvement. J. Clin. Lab. Immunol. 38: 175186.
52. Letendre, S.,, E. Lanier, and, J. McCutchan. 1999. Cerebrospinal fluid beta chemokine concentrations in neurocognitively impaired individuals infected with human immunodeficiency virus type 1. J. Infect. Dis. 180: 310319.
53. Letendre, S.,, J. Marquie-Beck,, K. Singh,, S. de Almeida,, J. Zimmerman,, S. Spector,, I. Grant, and, R. Ellis. 2004. The monocyte chemotactic protein-1-2578G allele is associated with elevated MCP-1 concentrations in cerebrospinal fluid. J. Neuroimmunol. 157: 193196.
54. Marra, C.,, D. Lockhart,, J. Zunt,, M. Perrin,, R. Coombs, and, A. Collier. 2003. Changes in CSF and plasma HIV-1 RNA and cognition after starting potent antiretroviral therapy. Neurology 60: 13881390.
55. Martin, C.,, J. Albert,, P. Hansson,, P. Pehrsson,, H. Link, and, A. Sonnerborg. 1998. Cerebrospinal fluid mononuclear cell counts influence CSF HIV-1 RNA levels. J. Acquir. Immun. Defic. Syndr. Hum. Retrovirol. 17: 214219.
56. McArthur, J.,, D. McClernon,, M. Cronin,, T. Nance-Sproson,, A. Saah,, M. St Clair, and, E. Lanier. 1997. Relationship between human immunodeficiency virus-associated dementia and viral load in cerebrospinal fluid and brain. Ann. Neurol. 42: 689- 698.
57. McArthur, J.,, T. Nance-Sproson,, D. Griffin,, D. Hoover,, O. Selnes,, E. Miller,, J. Margolick,, B. Cohen,, H. Farzadegan, and, A. Saah. 1992. The diagnostic utility of elevation in cerebrospinal fluid beta 2-microglobulin in HIV-1 dementia. Multicenter AIDS Cohort Study. Neurology 42: 17071712.
58. Miller, R.,, A. Green,, G. Giovannoni, and, E. Thompson. 2000. Detection of 14-3-3 brain protein in cerebrospinal fluid of HIV infected patients. Sex. Transm. Infect. 76: 408.
59. Monteiro de Almeida, S.,, S. Letendre,, J. Zimmerman,, D. Lazzaretto,, A. McCutchan, and, R. Ellis. 2005. Dynamics of monocyte chemoattractant protein type one (MCP-1) and HIV viral load in human cerebrospinal fluid and plasma. J. Neuroimmunol. 169: 144152.
60. Morgello, S.,, E. Cho,, S. Nielsen,, O. Devinsky, and, C. Petito. 1987. Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: an autopsy study of 30 cases and a review of the literature. Hum. Pathol. 18: 289297.
61. Morris, L.,, E. Silber,, P. Sonnenberg,, S. Eintracht,, S. Nyoka,, S. Lyons,, D. Saffer,, H. Koornhof, and, D. Martin. 1998. High human immunodeficiency virus type 1 RNA load in the cerebrospinal fluid from patients with lymphocytic meningitis. J. Infect. Dis. 177: 473476.
62. Nath, A.,, and J. Berger. 2004. HIV dementia. Curr. Treat. Options Neurol. 6: 139151.
63. Navia, B.,, E. Cho,, C. Petito, and, R. Price. 1986a. The AIDS dementia complex. II. Neuropathology. Ann. Neurol. 19: 525535.
64. Navia, B.,, B. Jordan, and, R. Price. 1986b. The AIDS dementia complex. I. Clinical features. Ann. Neurol. 19: 517524.
65. Navia, B.,, and R. Price. 2005. An overview of the clinical and biological features of the AIDS dementia complex, p. 339–356. In H. Gendelman,, I. Grant,, I. Everall,, S. Lipton, and, S. Swindells (ed.), The Neurology of AIDS. Oxford University Press, Oxford, United Kingdom.
66. Norgren, N.,, L. Rosengren, and, T. Stigbrand. 2003. Elevated neurofilament levels in neurological diseases. Brain Res. 987: 2531.
67. Pemberton, L.,, and B. Brew. 2001. Cerebrospinal fluid S-100beta and its relationship with AIDS dementia complex. J. Clin. Virol. 22: 249253.
68. Power, C.,, K. Zhang, and, G. van Marle. 2004. Comparative neurovirulence in lentiviral infections: the roles of viral molecular diversity and select proteases. J. Neurovirol. 10: 113117.
69. Power, C.,, J. McArthur,, R. Johnson,, D. Griffin,, J. Glass,, R. Dewey, and, B. Chesebro. 1995. Distinct HIV-1 env sequences are associated with neurotropism and neurovirulence. Curr. Top. Microbiol. Immunol. 202: 89104.
70. Price, R. 1995. Management of AIDS dementia complex and HIV-1 infection of the nervous system. AIDS 9 (A) : S221S236.
71. Price, R. 2000. The two faces of HIV infection of cerebrospinal fluid. Trends Microbiol. 8: 387391.
72. Ransohoff, R.,, P. Kivisakk, and, G. Kidd. 2003. Three or more routes for leukocyte migration into the central nervous system. Nat. Rev. Immunol. 3: 569581.
73. Reddy, R.,, C. Achim,, D. Sirko,, S. Tehranchi,, F. Kraus,, F. Wong-Staal, and, C. Wiley. 1996. Sequence analysis of the V3 loop in brain and spleen of patients with HIV encephalitis. AIDS Res. Hum. Retrovir. 12: 477482.
74. Ritola, K.,, C. Pilcher,, S. Fiscus,, N. Hoffman,, J. Nelson,, K. Kitrinos,, C. Hicks,, J. Eron, and, R. Swanstrom. 2004. Multiple V1/V2 env variants are frequently present during primary infection with human immunodeficiency virus type 1. J. Virol. 78: 1120811218.
75. Ritola, K.,, K. Robertson,, S. Fiscus,, C. Hall, and, R. Swanstrom. 2005. Increased human immunodeficiency virus type 1 (HIV-1) env compartmentalization in the presence of HIV-1-associated dementia. J. Virol. 79: 1083010834.
76. Robertson, K.,, W. Robertson,, S. Ford,, D. Watson,, S. Fiscus,, A. Harp, and, C. Hall. 2004. Highly active antiretroviral therapy improves neurocognitive functioning. J. Acquir. Immune Defic. Syndr. 36: 562566.
77. Rosengren, L.,, J. Karlsson,, J. Karlsson,, L. Persson, and, C. Wikkelso. 1996. Patients with amyotrophic lateral sclerosis and other neurodegenerative diseases have increased levels of neurofilament protein in CSF. J. Neurochem. 67: 20132018.
78. Rosengren, L.,, J. Karlsson,, M. Sjogren,, K. Blennow, and, A. Wallin. 1999. Neurofilament protein levels in CSF are increased in dementia. Neurology 52: 10901093.
79. Sabri, F.,, A. De Milito,, R. Pirskanen,, I. Elovaara,, L. Hagberg,, P. Cinque,, R. Price, and, F. Chiodi. 2001. Elevated levels of soluble Fas and Fas ligand in cerebrospinal fluid of patients with AIDS dementia complex. J. Neuroimmunol. 114: 197206.
80. Sacktor, N. 2002. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J. Neurovirol. 8: 115121.
81. Sevigny, J.,, S. Albert,, M. McDermott,, J. McArthur,, N. Sacktor,, K. Conant,, G. Schifitto,, O. Selnes,, Y. Stern,, D. McClernon,, D. Palumbo,, K. Kieburtz,, G. Riggs,, B. Cohen,, L. Epstein, and, K. Marder. 2004. Evaluation of HIV RNA and markers of immune activation as predictors of HIV-associated dementia. Neurology 63: 20842090.
82. Sporer, B.,, S. Kastenbauer,, U. Koedel,, G. Arendt, and, H. Pfister. 2003. Increased intrathecal release of soluble fractalkine in HIV-infected patients. AIDS Res. Hum. Retrovir. 19: 111116.
83. Sporer, B.,, U. Koedel,, F. Goebel, and, H. Pfister. 2000. Increased levels of soluble Fas receptor and Fas ligand in the cerebrospinal fluid of HIV-infected patients. AIDS Res. Hum. Retrovir. 16: 221226.
84. Sporer, B.,, U. Missler,, O. Magerkurth,, U. Koedel,, M. Wiesmann, and, H. Pfister. 2004. Evaluation of CSF glial fibrillary acidic protein (GFAP) as a putative marker for HIV-associated dementia. Infection 32: 2023.
85. Spudich, S.,, W. Huang,, A. Nilsson,, C. Petropoulos,, T. Liegler,, J. Whitcomb, and, R. Price. 2005a. HIV-1 chemokine coreceptor utilization in paired cerebrospinal fluid and plasma samples: a survey of subjects with viremia. J. Infect. Dis. 191: 890898.
86. Spudich, S.,, A. Nilsson,, N. Lollo,, T. Liegler,, C. Petropoulos,, S. Deeks,, E. Paxinos, and, R. Price. 2005b. Cerebrospinal fluid HIV infection and pleocytosis: relation to systemic infection and antiretroviral treatment. BMC Infect. Dis. 5: 98.
87. Strain, M.,, S. Letendre,, S. Pillai,, T. Russell,, C. Ignacio,, H. Gunthard,, B. Good,, D. Smith,, S. Wolinsky,, M. Furtado,, J. Marquie-Beck,, J. Durelle,, I. Grant,, D. Richman,, T. Marcotte,, J. McCutchan,, R. Ellis, and, J. Wong. 2005. Genetic composition of human immunodeficiency virus type 1 in cerebrospinal fluid and blood without treatment and during failing antiretroviral therapy. J. Virol. 79: 17721788.
88. Venturi, G.,, M. Catucci,, L. Romano,, P. Corsi,, F. Leoncini,, P. Valensin, and, M. Zazzi. 2000. Antiretroviral resistance mutations in human immunodeficiency virus type 1 reverse transcriptase and protease from paired cerebrospinal fluid and plasma samples. J. Infect. Dis. 181: 740745.
89. Wiley, C.,, and C. Achim. 1994. Human immunodeficiency virus encephalitis is the pathological correlate of dementia in acquired immunodeficiency syndrome. Ann. Neurol. 36: 673676.
90. Williams, K.,, S. Corey,, S. Westmoreland,, D. Pauley,, H. Knight,, C. deBakker,, X. Alvarez, and, A. Lackner. 2001. Perivascular macrophages are the primary cell type productively infected by simian immunodeficiency virus in the brains of macaques: implications for the neuropathogenesis of AIDS. J. Exp. Med. 193: 905915.
91. Williams, K.,, and W. Hickey. 2002. Central nervous system damage, monocytes and macrophages, and neurological disorders in AIDS. Annu. Rev. Neurosci. 25: 537562.
92. Williams, K.,, S. Westmoreland,, J. Greco,, E. Ratai,, M. Lentz,, W. Kim,, R. Fuller,, J. Kim,, P. Autissier,, P. Sehgal,, R. Schinazi,, N. Bischofberger,, M. Piatak,, J. Lifson,, E. Masliah, and, R. Gonzalez. 2005. Magnetic resonance spectroscopy reveals that activated monocytes contribute to neuronal injury in SIV neuroAIDS. J. Clin. Investig. 115: 25342545.
93. Wong, J.,, C. Ignacio,, F. Torriani,, D. Havlir,, N. Fitch, and, D. Richman. 1997. In vivo compartmentalization of human immunodeficiency virus: evidence from the examination of pol sequences from autopsy tissues. J. Virol. 71: 20592071.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error