Skip to main content
NCBI home page
Sexually Transmitted Infections logoLink to Sexually Transmitted Infections
. 2000 Dec;76(6):443–446. doi: 10.1136/sti.76.6.443

Cerebrospinal fluid tau concentrations in HIV infected patients with suspected neurological disease

A Green 1, G Giovannoni 1, M Hall-Craggs 1, E Thompson 1, R Miller 1
PMCID: PMC1744244  PMID: 11221126

Abstract

Objectives: To measure cerebrospinal fluid (CSF) tau in HIV infected patients with acute neurological episodes and to correlate the findings with the type and severity of neurological disease.

Methods: CSF tau was prospectively measured in 76 consecutive HIV infected patients admitted to a specialist unit at UCL Hospitals, London, for investigation of acute neurological episodes: the results were compared with the clinical diagnoses.

Results: 24 patients had HIV associated dementia complex (HADC), 10 had lymphoma (including four with primary CNS lymphoma), 20 had cerebral infections (including five with CMV encephalitis, five with VZV infection, seven with cryptococcal meningitis, two with toxoplasmosis, and one with progressive multifocal leucoencephalopathy); 22 patients had miscellaneous conditions, including nine with self limiting headache/fever. 62 patients (82%) had normal CSF tau concentration and 14 patients (18%) had elevated tau. In those with HADC, there was no correlation between the degree of dementia or atrophy on magnetic resonance imaging and CSF tau. Elevated CSF tau was associated with poor outcome as six of eight patients who died within 4 weeks of lumbar puncture had elevated tau (p=0.0024, two tailed Fisher's exact test).

Conclusions: CSF tau levels are not elevated in the majority of HIV infected patients presenting with acute neurological episodes. CSF tau levels show no correlation with severity of dementia/atrophy on magnetic resonance imaging. Although elevated CSF tau was observed in some patients with conditions causing cerebral necrosis, the finding did not delineate underlying pathology but was associated with poor outcome.

Key Words: tau; AIDS; cerebrospinal fluid; dementia; magnetic resonance imaging

Full Text

The Full Text of this article is available as a PDF (149.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arai H., Morikawa Y., Higuchi M., Matsui T., Clark C. M., Miura M., Machida N., Lee V. M., Trojanowski J. Q., Sasaki H. Cerebrospinal fluid tau levels in neurodegenerative diseases with distinct tau-related pathology. Biochem Biophys Res Commun. 1997 Jul 18;236(2):262–264. doi: 10.1006/bbrc.1997.6908. [DOI] [PubMed] [Google Scholar]
  2. Arai H., Terajima M., Miura M., Higuchi S., Muramatsu T., Machida N., Seiki H., Takase S., Clark C. M., Lee V. M. Tau in cerebrospinal fluid: a potential diagnostic marker in Alzheimer's disease. Ann Neurol. 1995 Oct;38(4):649–652. doi: 10.1002/ana.410380414. [DOI] [PubMed] [Google Scholar]
  3. Ellis R. J., Seubert P., Motter R., Galasko D., Deutsch R., Heaton R. K., Heyes M. P., McCutchan J. A., Atkinson J. H., Grant I. Cerebrospinal fluid tau protein is not elevated in HIV-associated neurologic disease in humans. HIV Neurobehavioral Research Center Group (HNRC). Neurosci Lett. 1998 Sep 18;254(1):1–4. doi: 10.1016/s0304-3940(98)00549-7. [DOI] [PubMed] [Google Scholar]
  4. Everall I. P., Glass J. D., McArthur J., Spargo E., Lantos P. Neuronal density in the superior frontal and temporal gyri does not correlate with the degree of human immunodeficiency virus-associated dementia. Acta Neuropathol. 1994;88(6):538–544. doi: 10.1007/BF00296490. [DOI] [PubMed] [Google Scholar]
  5. Galasko D., Clark C., Chang L., Miller B., Green R. C., Motter R., Seubert P. Assessment of CSF levels of tau protein in mildly demented patients with Alzheimer's disease. Neurology. 1997 Mar;48(3):632–635. doi: 10.1212/wnl.48.3.632. [DOI] [PubMed] [Google Scholar]
  6. Giometto B., An S. F., Groves M., Scaravilli T., Geddes J. F., Miller R., Tavolato B., Beckett A. A., Scaravilli F. Accumulation of beta-amyloid precursor protein in HIV encephalitis: relationship with neuropsychological abnormalities. Ann Neurol. 1997 Jul;42(1):34–40. doi: 10.1002/ana.410420108. [DOI] [PubMed] [Google Scholar]
  7. Goedert M., Crowther R. A., Garner C. C. Molecular characterization of microtubule-associated proteins tau and MAP2. Trends Neurosci. 1991 May;14(5):193–199. doi: 10.1016/0166-2236(91)90105-4. [DOI] [PubMed] [Google Scholar]
  8. Green A. J., Harvey R. J., Thompson E. J., Rossor M. N. Increased tau in the cerebrospinal fluid of patients with frontotemporal dementia and Alzheimer's disease. Neurosci Lett. 1999 Jan 8;259(2):133–135. doi: 10.1016/s0304-3940(98)00904-5. [DOI] [PubMed] [Google Scholar]
  9. Harrison M. J., Newman S. P., Hall-Craggs M. A., Fowler C. J., Miller R., Kendall B. E., Paley M., Wilkinson I., Sweeney B., Lunn S. Evidence of CNS impairment in HIV infection: clinical, neuropsychological, EEG, and MRI/MRS study. J Neurol Neurosurg Psychiatry. 1998 Sep;65(3):301–307. doi: 10.1136/jnnp.65.3.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Miller R. F., Lucas S. B., Hall-Craggs M. A., Brink N. S., Scaravilli F., Chinn R. J., Kendall B. E., Williams I. G., Harrison M. J. Comparison of magnetic resonance imaging with neuropathological findings in the diagnosis of HIV and CMV associated CNS disease in AIDS. J Neurol Neurosurg Psychiatry. 1997 Apr;62(4):346–351. doi: 10.1136/jnnp.62.4.346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Report of a Working Group of the American Academy of Neurology AIDS Task Force. Neurology. 1991 Jun;41(6):778–785. doi: 10.1212/wnl.41.6.778. [DOI] [PubMed] [Google Scholar]
  12. Otto M., Wiltfang J., Tumani H., Zerr I., Lantsch M., Kornhuber J., Weber T., Kretzschmar H. A., Poser S. Elevated levels of tau-protein in cerebrospinal fluid of patients with Creutzfeldt-Jakob disease. Neurosci Lett. 1997 Apr 11;225(3):210–212. doi: 10.1016/s0304-3940(97)00215-2. [DOI] [PubMed] [Google Scholar]
  13. Paley M. N., Chong W. K., Wilkinson I. D., Shepherd J. K., Clews A. M., Sweeney B. J., Hall-Craggs M. A., Kendall B. E., Newman S. P., Harrison M. J. Cerebrospinal fluid-intracranial volume ratio measurements in patients with HIV infection: CLASS image analysis technique. Radiology. 1994 Mar;190(3):879–886. doi: 10.1148/radiology.190.3.8115644. [DOI] [PubMed] [Google Scholar]
  14. Price R. W., Brew B. J. The AIDS dementia complex. J Infect Dis. 1988 Nov;158(5):1079–1083. doi: 10.1093/infdis/158.5.1079. [DOI] [PubMed] [Google Scholar]
  15. Stanley L. C., Mrak R. E., Woody R. C., Perrot L. J., Zhang S., Marshak D. R., Nelson S. J., Griffin W. S. Glial cytokines as neuropathogenic factors in HIV infection: pathogenic similarities to Alzheimer's disease. J Neuropathol Exp Neurol. 1994 May;53(3):231–238. doi: 10.1097/00005072-199405000-00003. [DOI] [PubMed] [Google Scholar]
  16. Vandermeeren M., Mercken M., Vanmechelen E., Six J., van de Voorde A., Martin J. J., Cras P. Detection of tau proteins in normal and Alzheimer's disease cerebrospinal fluid with a sensitive sandwich enzyme-linked immunosorbent assay. J Neurochem. 1993 Nov;61(5):1828–1834. doi: 10.1111/j.1471-4159.1993.tb09823.x. [DOI] [PubMed] [Google Scholar]

Articles from Sexually Transmitted Infections are provided here courtesy of BMJ Publishing Group

RESOURCES