Serum and Cerebrospinal Fluid

De novo synthesis in the central nervous system of IgG antibodies to human T cell lymphotropic virus type III (HTLVHI) (lymphadenopathy associated virus) was shown in seven of 10 seropositive men who had syphilis but not the acquired immune deficiency syndrome (AIDS) or AIDS related complex. None of these men showed neurological symptoms when the serum and cerebrospinal fluid were collected. Pleocytosis was present in all 10. Of the seven men who showed evidence of intrathecal synthesis ofantibodies, five had increased total concentrations of IgG and four had oligoclonal IgG bands in their cerebrospinal fluid. Oligoclonal bands were also present in one man who did not have any antibodies. Longitudinal study of one man showed that seroconversion preceded intrathecal synthesis of antibody specific to HTLV-III. The appearance of antibody in the cerebrospinal fluid was accompanied by a transient rise in mononuclear cell count and the appearance ofoligoclonal bands. The presence of clones of B cells specific to HTLV-Ill in the central nervous system of these patients without persisting neurological symptoms suggests thatHTLV-II1 enters the central nervous system in the early stages of infection. Department of Virology, Academic Medical Centre, University of Amsterdam, The Netherlands J GOUDSMIT, MD, PHD, virologist M BAKKER, technician L SMIT, technician J VAN DER NOORDAA, MD, PHD, virologist and head of department Department of Neurology, Academic Hospital, Vrije University of Amsterdam, The Netherlands E C WOLTERS, MD, PHD, neurologist Department ofNeurology and Clinical Chemistry, Academic Medical Centre, University ofAmsterdam, The Netherlands E A H HISCHE, technician J A TUTUARIMA, technician H J VAN DER HELM, PHD, clinical chemist and head ofdepartment Correspondence to: Dr J Goudsmit, Department of Virology, L1-153, Academic Medical Centre, Meibergdreef 15, 1105 AZ Amsterdam, Netherlands. L SMIT, J VAN DER NOORDAA, DER HELM