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Brain tissue was examined for evidence of human immunodeficiency virus (HIV) infection in 23 intravenous drug users who died suddenly some years after seroconversion but while still in presymptomatic stages of infection. None showed giant cell encephalitis, but 14 showed T cell lymphocytic leptomeningitis and 3 showed other significant neuropathologic features. Quantitative polymerase chain reaction for HIV was applied to 13 of the 23 with negative results in 6 and very low positive results in the other 7, a finding consistent with contamination by residual infected blood in the brain tissue. This contrasted with findings in AIDS-infected tissue, in which substantial amounts of provirus were found. It is concluded that significant infection in brain tissue does not occur in presymptomatic stages of HIV infection and that invasion of the central nervous system may be delayed until the transition to symptomatic AIDS.

Original publication

DOI

10.1093/infdis/168.4.818

Type

Journal article

Journal

J Infect Dis

Publication Date

10/1993

Volume

168

Pages

818 - 824

Keywords

Acquired Immunodeficiency Syndrome, Adult, Autopsy, Brain, Death, Sudden, Female, HIV, HIV Seropositivity, Humans, Lymphocytes, Male, Polymerase Chain Reaction, Reference Values, Substance Abuse, Intravenous