The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia

Multicenter AIDS Cohort Study

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

We measured serum and CSF β2-microglobulin (β2M) levels in HIV-1 seropositive individuals with and without dementia to determine the frequency and diagnostic utility of elevation of CSF β32M. We compared 34 samples from 27 patients with HIV-1 dementia with 110 samples from 54 HIV-1 seropositive participants in the Multicenter AIDS Cohort Study, none of whom had progressive dementia. Neurosyphilis and CNS opportunistic processes were excluded in all subjects. We stratified the nondemented subjects by duration of HIV seropositivity and peripheral blood CD4 count. Compared with the nondemented group, demented subjects had significantly higher CSF total protein, IgG%, and CSF albumin/serum albumin ratios. A highly significant association was found between elevated CSF β2M and reduced CD4 count (p< 0.0001). No significant differences were noted between the demented and nondemented groups in CSF WBC count or in the frequency of CSF HIV-1 isolation. The mean CSF β2M was 1.9 mg/l in the nondemented subjects compared with 4.2 mg/l in those with dementia (p< 0.0001). We derived a cutoff of 3.8 mg/l from the distribution of CSF β2M in the nondemented group. The determination of CSF β2M had a sensitivity of 44%, specificity of 90%, and a positive predictive value of 88% for diagnosis of HIV dementia when compared with nondemented subjects with CD4 counts<200. In those without dementia, there was a strong correlation between serum and CSF β2M (r = 0.50, p< 0.0001), but in demented subjects CSF β2M was elevated independently of serum levels, suggesting that CSF β2M is produced within the brain in HIV dementia. In the absence of CNS opportunistic processes, elevated CSF β2M >3.8 mg/l is a clinically useful marker for HIV dementia.

Original languageEnglish (US)
Pages (from-to)1707-1712
Number of pages6
JournalNeurology
Volume42
Issue number9
StatePublished - Jan 1 1992
Externally publishedYes

Fingerprint

AIDS Dementia Complex
Cerebrospinal Fluid
Dementia
HIV-1
Granulocyte-Macrophage Colony-Stimulating Factor
CD4 Lymphocyte Count
HIV Seropositivity
Neurosyphilis
Serum Albumin
Albumins
Acquired Immunodeficiency Syndrome
Cohort Studies
Immunoglobulin G
Serum
Proteins

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Multicenter AIDS Cohort Study. / The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia. In: Neurology. 1992 ; Vol. 42, No. 9. pp. 1707-1712.
@article{eca2d246238a4ba79d29a2502dd040fe,
title = "The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia",
abstract = "We measured serum and CSF β2-microglobulin (β2M) levels in HIV-1 seropositive individuals with and without dementia to determine the frequency and diagnostic utility of elevation of CSF β32M. We compared 34 samples from 27 patients with HIV-1 dementia with 110 samples from 54 HIV-1 seropositive participants in the Multicenter AIDS Cohort Study, none of whom had progressive dementia. Neurosyphilis and CNS opportunistic processes were excluded in all subjects. We stratified the nondemented subjects by duration of HIV seropositivity and peripheral blood CD4 count. Compared with the nondemented group, demented subjects had significantly higher CSF total protein, IgG{\%}, and CSF albumin/serum albumin ratios. A highly significant association was found between elevated CSF β2M and reduced CD4 count (p< 0.0001). No significant differences were noted between the demented and nondemented groups in CSF WBC count or in the frequency of CSF HIV-1 isolation. The mean CSF β2M was 1.9 mg/l in the nondemented subjects compared with 4.2 mg/l in those with dementia (p< 0.0001). We derived a cutoff of 3.8 mg/l from the distribution of CSF β2M in the nondemented group. The determination of CSF β2M had a sensitivity of 44{\%}, specificity of 90{\%}, and a positive predictive value of 88{\%} for diagnosis of HIV dementia when compared with nondemented subjects with CD4 counts<200. In those without dementia, there was a strong correlation between serum and CSF β2M (r = 0.50, p< 0.0001), but in demented subjects CSF β2M was elevated independently of serum levels, suggesting that CSF β2M is produced within the brain in HIV dementia. In the absence of CNS opportunistic processes, elevated CSF β2M >3.8 mg/l is a clinically useful marker for HIV dementia.",
author = "{Multicenter AIDS Cohort Study} and McArthur, {Justin C.} and Nance-Sproson, {T. E.} and Griffin, {D. E.} and Donald Hoover and Selnes, {O. A.} and Miller, {E. N.} and Margolick, {J. B.} and Cohen, {B. A.} and H. Farzadegan and A. Saah and Debbie Hasenauer and McArthur, {Julie H.} and John Palenicek and Sharon Metz and Lisa Jacobson and Alvaro Munoz and Jerry Wesch and Chmiel, {Joan S.} and Phair, {John P.} and Roger Detels and Jan Dudley and Paul Satz and {Van Gorp}, Wilfred and Barbara Visscher and Becker, {James T.} and Charles Rinaldo and Lew Schrager and Sten Vermund",
year = "1992",
month = "1",
day = "1",
language = "English (US)",
volume = "42",
pages = "1707--1712",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

Multicenter AIDS Cohort Study 1992, 'The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia', Neurology, vol. 42, no. 9, pp. 1707-1712.

The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia. / Multicenter AIDS Cohort Study.

In: Neurology, Vol. 42, No. 9, 01.01.1992, p. 1707-1712.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The diagnostic utility of elevation in cerebrospinal fluid β2–microglobulin in HIV–1 dementia

AU - Multicenter AIDS Cohort Study

AU - McArthur, Justin C.

AU - Nance-Sproson, T. E.

AU - Griffin, D. E.

AU - Hoover, Donald

AU - Selnes, O. A.

AU - Miller, E. N.

AU - Margolick, J. B.

AU - Cohen, B. A.

AU - Farzadegan, H.

AU - Saah, A.

AU - Hasenauer, Debbie

AU - McArthur, Julie H.

AU - Palenicek, John

AU - Metz, Sharon

AU - Jacobson, Lisa

AU - Munoz, Alvaro

AU - Wesch, Jerry

AU - Chmiel, Joan S.

AU - Phair, John P.

AU - Detels, Roger

AU - Dudley, Jan

AU - Satz, Paul

AU - Van Gorp, Wilfred

AU - Visscher, Barbara

AU - Becker, James T.

AU - Rinaldo, Charles

AU - Schrager, Lew

AU - Vermund, Sten

PY - 1992/1/1

Y1 - 1992/1/1

N2 - We measured serum and CSF β2-microglobulin (β2M) levels in HIV-1 seropositive individuals with and without dementia to determine the frequency and diagnostic utility of elevation of CSF β32M. We compared 34 samples from 27 patients with HIV-1 dementia with 110 samples from 54 HIV-1 seropositive participants in the Multicenter AIDS Cohort Study, none of whom had progressive dementia. Neurosyphilis and CNS opportunistic processes were excluded in all subjects. We stratified the nondemented subjects by duration of HIV seropositivity and peripheral blood CD4 count. Compared with the nondemented group, demented subjects had significantly higher CSF total protein, IgG%, and CSF albumin/serum albumin ratios. A highly significant association was found between elevated CSF β2M and reduced CD4 count (p< 0.0001). No significant differences were noted between the demented and nondemented groups in CSF WBC count or in the frequency of CSF HIV-1 isolation. The mean CSF β2M was 1.9 mg/l in the nondemented subjects compared with 4.2 mg/l in those with dementia (p< 0.0001). We derived a cutoff of 3.8 mg/l from the distribution of CSF β2M in the nondemented group. The determination of CSF β2M had a sensitivity of 44%, specificity of 90%, and a positive predictive value of 88% for diagnosis of HIV dementia when compared with nondemented subjects with CD4 counts<200. In those without dementia, there was a strong correlation between serum and CSF β2M (r = 0.50, p< 0.0001), but in demented subjects CSF β2M was elevated independently of serum levels, suggesting that CSF β2M is produced within the brain in HIV dementia. In the absence of CNS opportunistic processes, elevated CSF β2M >3.8 mg/l is a clinically useful marker for HIV dementia.

AB - We measured serum and CSF β2-microglobulin (β2M) levels in HIV-1 seropositive individuals with and without dementia to determine the frequency and diagnostic utility of elevation of CSF β32M. We compared 34 samples from 27 patients with HIV-1 dementia with 110 samples from 54 HIV-1 seropositive participants in the Multicenter AIDS Cohort Study, none of whom had progressive dementia. Neurosyphilis and CNS opportunistic processes were excluded in all subjects. We stratified the nondemented subjects by duration of HIV seropositivity and peripheral blood CD4 count. Compared with the nondemented group, demented subjects had significantly higher CSF total protein, IgG%, and CSF albumin/serum albumin ratios. A highly significant association was found between elevated CSF β2M and reduced CD4 count (p< 0.0001). No significant differences were noted between the demented and nondemented groups in CSF WBC count or in the frequency of CSF HIV-1 isolation. The mean CSF β2M was 1.9 mg/l in the nondemented subjects compared with 4.2 mg/l in those with dementia (p< 0.0001). We derived a cutoff of 3.8 mg/l from the distribution of CSF β2M in the nondemented group. The determination of CSF β2M had a sensitivity of 44%, specificity of 90%, and a positive predictive value of 88% for diagnosis of HIV dementia when compared with nondemented subjects with CD4 counts<200. In those without dementia, there was a strong correlation between serum and CSF β2M (r = 0.50, p< 0.0001), but in demented subjects CSF β2M was elevated independently of serum levels, suggesting that CSF β2M is produced within the brain in HIV dementia. In the absence of CNS opportunistic processes, elevated CSF β2M >3.8 mg/l is a clinically useful marker for HIV dementia.

UR - http://www.scopus.com/inward/record.url?scp=0026671307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026671307&partnerID=8YFLogxK

M3 - Article

VL - 42

SP - 1707

EP - 1712

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 9

ER -