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NEUROLOGY 1989;39:892
© 1989 American Academy of Neurology

Dissociation of AIDS-related vacuolar myelopathy and productive HIV-1 infection of the spinal cord

M. Rosenblum, MD, A. C. Scheck, PhD, K. Cronin, BA, B. J. Brew, MBBS, A. Khan, MS, M. Paul, PhD and R. W. Price, MD

Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY (Dr. Scheck, Ms. Cronin, Dr. Brew, Ms. Khan, and Drs. Paul and Price)
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY. (Dr. Rosenblum)

Although merging clinically within the spectrum of the AIDS dementia complex, vacuolar myelopathy is a pathologically distinct entity detected in up to 30% of autopsied patients succumbing to the late complications of human immunodeficiency virus type 1 (HIV-1) infection. Using immunohistochemistry and in situ hybridization to detect an HIV-1 core protein and viral mRNA, respectively, in tissue sections, and culture isolation to assess infectious virus in tissue homogenates, we found that vacuolar myelopathy was independent of productive HIV-1 infection of the spinal cord and brain. These results indicate that AIDS-associated vacuolar myelopathy is either not related directly to spinal cord HIV-1 infection or involves nonproductive infection and pathobiological processes distinct from those responsible for the multinucleated-cell inflammatory infiltrates that serve as histopathologic markers of productive CNS HIV-1 infection.

Address correspondence and reprint requests to Dr. Price, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021.

Supported by US Public Health Service Research Grant NS-25701 and a grant from the Rudin Foundation.

Received November 30,1988. Accepted for publication in final form January 17,1989.




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