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Neurologic Abnormalities and Recovery of Human Immunodeficiency Virus from Cerebrospinal Fluid

HARRY HOLLANDER, M.D.; and JAY A. LEVY, M.D.
[+] Article and Author Information

Grant support: in part by a grant from the California State University wide Task Force on AIDS.

▸Requests for reprints should be addressed to Harry Hollander, M.D.; Department of Medicine, Box 324, A555, University of California, San Francisco; San Francisco, CA 94143.


San Francisco, California


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(5):692-695. doi:10.7326/0003-4819-106-5-692
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Infectious human immunodeficiency virus (HIV) was recovered from 30 of 48 cerebrospinal fluid specimens from seropositive persons with and without neurologic symptoms or disease. Of 16 patients with only neurologic problems or other HIV-related conditions, but not the acquired immunodeficiency syndrome (AIDS), 11 had virus recovered; over half of those with AIDS also had virus isolated. Patients with headache or altered mental status had the highest recovery rate of HIV from cerebrospinal fluid. Although virus was primarily found in patients with detectable neurologic disease, it was also isolated from 5 of 8 patients with normal neurologic examinations. Two of these patients had fever alone. The presence of virus in cerebrospinal fluid did not necessarily correlate with isolation of virus from the serum. These findings suggest that HIV may at times replicate preferentially in the brain and that its presence may not immediately cause neurologic signs or symptoms.

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