Angiocentric CD3+ T-Cell Infiltrates in HIV-1-Associated CNS Disease in Children

CD3+ T-CELL INFILTRATES IN HIV-1-ASSOCIATED CNS DISEASE IN

brains examined at autopsy from children with AIDS show evidence

of mononuclear cell infiltration. Previous studies have shown

that these infiltrates are composed primarily of

monocytes/macrophages. We report here the presence of

angiocentric infiltrates comprised primarily of T cells in the

brains of children with AIDS. Perivascular infiltrates were found

in autopsy specimens from 5 of 6 children with AIDS and consisted

of CD3+ T-cells and in some cases, equal or greater proportions

of CD68+ monocytes/macrophages. Transmural mononuclear cell

infiltrates were found in one patient that consisted primarily of

CD3+ T cells, with an almost equal amount of CD68+ monocyte/

macrophages found only in certain vessels. There was a clear

majority of CD3+ T cells on the endothelial side of transmural

infiltrates. The majority of these cells were also CD8+ and

CD45R0+. The intervening brain neuropil, however, was dominated

by monocytes/macrophages/microglia, and reactive astrocytes with

very few CD3+/CD8+ cells present. Five of six patients showed

evidence of calcific vasculopathy, with only two exhibiting

HIV-1-encephalitis. One patient had multiple infarcts indicative

of a widespread mononuclear cell vasculitis. A second patient had

an old infarct associated with fibrointimal thickening of the

leptomeningeal vessels. These infiltrating T cells may be

responsible for HIV-1 associated CNS vasculitis and vasculopathy,

for endothelial cell injury, and for comprising the