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Neurology Services, Albuquerque Veterans Affairs Medical Center, Albuquerque, NM (Dr. Davis)
Medical Services, Albuquerque Veterans Affairs Medical Center, Albuquerque, NM (Dr. Palmer)
Pathology Services, Albuquerque Veterans Affairs Medical Center, Albuquerque, NM (Drs. Llewellyn and Merlin)
Departments of Neurology, University of New Mexico School of Medicine, Albuquerque, NM (Dr. Davis)
Departments of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (Drs. Hjelle and Miller)
Departments of Microbiology, University of New Mexico School of Medicine, Albuquerque, NM (Dr. Young and R.G. Mills)
Research Service, San Diego Veterans Affairs Medical Center, University of California, San Diego, CA (Dr. Wachsman)
Division of Hematology-Oncology, University of California, San Diego, CA (Dr. Wachsman)
Department of Pathology, University of California, San Diego, CA (Dr. Wiley).
We report a 68-year-old man who received an IV inoculation of WBCs for an indium radionuclide scan containing 600 to 700 tissue culture infectious doses of human immunodeficiency virus type 1 (HIV-1) from an HIV-1-infected individual. The recipient immediately received zidovudine, then was switched to dideoxyinosine and interferon-
, but died of hepatorenal syndrome and hepatic encephalopathy 15 days later. HIV-1 cultures were positive from the recipient's blood on day 14 but not days 0, 1, and 8. At autopsy, cultures of parietal lobe isolated HIV-1. HIV-1 nucleic acid was present in several brain areas, but not in several other organs, by two independent laboratories using the polymerase chain reaction. The brain showed mild perivascular cuffing and a mild lymphocytic meningitis, but there was no evidence of glial nodules, giant cells, or white matter abnormalities. HIV-1 gp41 viral antigen was seen by immunoperoxidase staining in rare infiltrating cells within perivascular and subpial spaces. Thus, HIV-1 was isolated from brain 15 days after mistaken HIV-1 inoculation and 1 day after virus was first recovered from blood.
Supported by the Research Service, Department of Veterans Affairs, Blood Systems Research Foundation, NIH grants R01 CA55480, NS-25178 and NS-27810, University of California AIDS task force grant, and the San Diego VAMC Research Center on AIDS and HIV infection. Dr. Wachsman is the recipient of a VA Clinical Investigation award.
Address correspondence and reprint requests to Dr. Larry E. Davis, Neurology Service, Albuquerque VA Medical Center, 2100 Ridgecrest Drive SE Albuquerque, NM 87108
Received November 6, 1991. Accepted for publication in final form February 27, 1992.
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