Brain choline-containing compounds are elevated in HIV-positive patients before the onset of AIDS dementia complex

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Abstract
Pathologic lesions in ADC are predominantly localized to white and deep gray matter structures and typically include pallor of the white matter, gliosis, and perivascular and parenchymal infiltrates of macrophages, lymphocytes, and multinucleated giant cells. [1,2,6,7] By using quantitative morphometry, several groups found a 30 to 50% loss of large neurons in the cortical regions of patients with HIV encephalitis [6,8] and in brains with minimal pathology. [9,10] Confocal laser imaging and golgi impregnation studies also identified abnormalities of the dendritic tree, including a 40% loss of the dendritic area and 40 to 60% loss of spine density compared with controls. [11] The relationship of these findings to the severity of dementia remains poorly understood, however. Although HIV is thought to be the causative agent of ADC, neurons and glial cells are not commonly infected, [12-14] suggesting that brain injury may be related to indirect mechanisms. [15,16]