Background:  The significance of cerebrospinal fluid (CSF) viral load for cerebral dysfunction in HIV-1⁺ patients is unclear. This study presents the results of a broad neuropsychological test battery that was used to examine 142 HIV⁺ patients without overt neurological deficits.

Methods:  Patients were recruited consecutively. Of 142 patients, 111 HIV-1 carriers had higher plasma than CSF viral load and, of these, 33 (22.9 %) vice versa. Both patient groups were subdivided into 6 subgroups: Groups 1 and 2 = early CDC stage (A1+2, B1+2) patients ± HAART, groups 3 and 4 = late CDC stage (A3, B3, C1-3) patients ± HAART, groups 5 and 6 = drug abusers ± HAART. Tests applied to all individuals were:

For pure motor test, motor test battery; motor/cognitive tests, Trail Making Test Form A + B (TMT A + B) and Digit Symbol Test (DST); motor/cognitive/visual test, Grooved Pegboard Test (GPT); pure cognitive tests, AIDS Dementia Scale (ADS), Syndrome Short Test (SST), Digit Span Test (DST), Logical Memory Test I + II, and Mosaik Test

Results:  All the other tests were normal.

Conclusions:  HIV-1⁺ patients without overt clinical deficits, but with higher CSF than plasma viral load—a surprisingly high percentage in this cohort—showed marked pathological neuropsychological test profiles in contrast to individuals with higher plasma viral load who reveal only mild to moderate motor, but no cognitive deficits. The reasons for these findings must be evaluated in further studies.