Neuropathology of Acquired Immunodeficiency Syndrome (AIDS)

Petito, Carol K.; Cho, E S; Lemann, W; Navia, Bradford; Price, Richard W.

doi:10.1097/00005072-198611000-00003

Cited by 427 publications

(134 citation statements)

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“…Human immunodeficiency virus type 1 (HIV-1) replication in the brain results in the development of severe neurological disorders known as AIDS dementia complex in about 30% of AIDS patients (29). The mechanisms that cause the loss of up to 40% of neurons (10) as well as result in dementia are unclear.…”

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confidence: 99%

Biological Analysis of Human Immunodeficiency Virus Type 1 R5 Envelopes Amplified from Brain and Lymph Node Tissues of AIDS Patients with Neuropathology Reveals Two Distinct Tropism Phenotypes and Identifies Envelopes in the Brain That Confer an Enhanced Tropism and Fusigenicity for Macrophages

Peters

Bhattacharya

Hibbitts

et al. 2004

J Virol

183

282

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Complete envelope genes were amplified from autopsy brain tissue of five individuals who had died of AIDS and had neurological complications. Lymph node samples were included for two of the patients. Nineteen different envelope clones from the five patients had distinct V1V2 sequences. Thirteen of the envelopes were functional and conferred fusigenicity and infectivity for CD4 ؉ CCR5 ؉ cells. Infectivity and cell-cell fusion assays showed that most envelopes used both CCR5 and CCR3. One brain-derived envelope used a broad range of coreceptors, while three other brain envelopes from one individual were restricted to CCR5. However, there was no correlation between tissue of origin and coreceptor use. Envelopes showed two very distinct phenotypes depending on their capacity to infect macrophages and to exploit low levels of CD4 and/or CCR5 for infection. Envelopes that were highly fusigenic and tropic for macrophages were identified in brain tissue from four of the five patients. The enhanced macrophage tropism correlated with reduced sensitivity to inhibition by Q4120, a CD4-specific antibody, but not with sensitivity to the CCR5 inhibitor, TAK779. The highly macrophage-tropic envelopes were able to infect cells expressing low levels of CD4 and/or CCR5. Comparison with several wellcharacterized macrophage-tropic envelopes showed that the four identified patient envelopes were at the top limit of macrophage tropism. In contrast, all four lymph node-derived envelopes exhibited a non-macrophagetropic phenotype and required high levels of CD4 for infection. Our data support the presence of envelopes that are highly fusigenic and tropic for macrophages in the brains of patients with neurological complications. These envelopes are able to infect cells that express low levels of CD4 and/or CCR5 and may have adapted for replication in brain macrophages and microglia, which are known to express limited amounts of CD4.Human immunodeficiency virus type 1 (HIV-1) replication in the brain results in the development of severe neurological disorders known as AIDS dementia complex in about 30% of AIDS patients (29). The mechanisms that cause the loss of up to 40% of neurons (10) as well as result in dementia are unclear. In the rhesus macaque simian immunodeficiency virus (SIV) model, both neurotropic and neurovirulent SIV MAC variants have been described (11,22,38). It is therefore suspected that specific neurotropic and neurovirulent HIV-1 variants exist and are associated with dementia.CCR5-using HIV-1 strains are predominant in the brain (13), and CCR5 ϩ perivascular macrophages and microglia are the cell types most frequently infected (19,35,37,43,49,50). The role of other cell types resident in the brain is less clear. There is evidence that CD4Ϫ astrocytes become infected, particularly in pediatric AIDS cases (32,36,37,43). Astrocyte infection is relatively unproductive with early HIV mRNAs (e.g., for rev and nef) detectable, but no late mRNAs encoding the structural gag and env proteins needed to produce progeny virus par...

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mentioning

confidence: 99%

Biological Analysis of Human Immunodeficiency Virus Type 1 R5 Envelopes Amplified from Brain and Lymph Node Tissues of AIDS Patients with Neuropathology Reveals Two Distinct Tropism Phenotypes and Identifies Envelopes in the Brain That Confer an Enhanced Tropism and Fusigenicity for Macrophages

Peters

Bhattacharya

Hibbitts

et al. 2004

J Virol

183

282

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“…One clinical survey showed that neurological disorders occur in 40% of adult AIDS patients, 10 while post-mortem studies reveal neuropathology in 70-80% of AIDS patients. 11 Of those with neurological manifestations, 41% have opportunistic infections. 12 The organisms most frequently involved are toxoplasma, cryptococcus, cytomegalovirus (CMV), and herpes zoster.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of HIV infection in ophthalmic practice

Wadood

Dhillon

McIlwaine

et al. 2004

Eye

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“…These complications occur at all stages of infection and involve any level of central and peripheral nervous system (4)(5)(6). Approximately at least 10% of patients present with a neurologic complaint (5-7), 30 to 50% develop neurologic complications during the course of the disease (4)(5)(6), and up to 90% show pathologic evidence of neurologic disease at autopsy (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Neurologic Complications of Human Immunodeficiency Virus-type 1 Infection

Kim

Lee

et al. 2003

J Korean Med Sci

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A wide variety of neurologic complications associated with human immunodeficiency virus-type 1 (HIV-1) infection result from HIV-1 itself or secondarily related to immunosuppression. In Korea, the number of HIV-1 seropositive populations is increasing, but little has been known about the neurologic complications of HIV-1 infection. To investigate the neurologic complications in HIV-1 infected Korean patients, we performed a cross-sectional study in consecutive admissions to the Seoul National University Hospital between March 1998 and June 1999. Thirty-four HIV-1 seropositive patients were included. As a result, a total of 26 HIV-1 related neurologic complications were identified from 17 patients. Among them, 10 patients showed cognitive/motor abnormalities: 3 HIV-1-associated dementia and 7 possible HIV-1-associated minor cognitive/motor disorder. Neuromuscular complications were found in 10 patients: 9 distal symmetric polyneuropathy, and 1 possible chronic inflammatory demyelinating polyradiculoneuropathy. In 3 patients with focal brain lesions, 2 were presumptively diagnosed as having primary CNS lymphoma, and 1 as having progressive multifocal leukoencephalopathy in the posterior fossa, based on history, clinical findings, serology, radiological appearances, and response to empirical therapy. Other complications included cryptococcal meningitis and only soft neurologic signs without any neurologic disease. Most of these complications (88%) occurred in the advanced stage of infection.

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Neuropathology of Acquired Immunodeficiency Syndrome (AIDS)

Cited by 427 publications

References 0 publications

Biological Analysis of Human Immunodeficiency Virus Type 1 R5 Envelopes Amplified from Brain and Lymph Node Tissues of AIDS Patients with Neuropathology Reveals Two Distinct Tropism Phenotypes and Identifies Envelopes in the Brain That Confer an Enhanced Tropism and Fusigenicity for Macrophages

Biological Analysis of Human Immunodeficiency Virus Type 1 R5 Envelopes Amplified from Brain and Lymph Node Tissues of AIDS Patients with Neuropathology Reveals Two Distinct Tropism Phenotypes and Identifies Envelopes in the Brain That Confer an Enhanced Tropism and Fusigenicity for Macrophages

Delayed diagnosis of HIV infection in ophthalmic practice

Neurologic Complications of Human Immunodeficiency Virus-type 1 Infection

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