Human immunodeficiency virus (HIV)-1-associated
dementia is a frequent consequence of
HIV infection and is associated with neuronal deficits. Increased concentrations of the
kynurenine pathway metabolites
3-hydroxykynurenine (3-HK) and
quinolinic acid (QA) may contribute to this neuronal damage. We measured 3-HK concentrations and the activity of its catabolising
enzyme,
3-hydroxykynureninase, in postmortem brain tissue from eight controls and 32 HIV-positive patients, including a group that exhibited
dementia. 3-HK concentrations were significantly increased (over threefold) in the HIV-positive group when compared with controls. This increase was greater in those patients with
dementia, but it was still apparent in the nondemented cases.
3-Hydroxykynureninase activity was significantly increased in the HIV-infected group compared with the control values. The effect was apparent in both nondementia and
dementia cases, although the latter showed a slightly greater increase. The 3-HK content increase is thus unrelated to a reduction in activity of this
enzyme and is likely to reflect an overall increase in the kynurenic metabolic pathway. Elevated levels of the
neurotoxin 3-HK may contribute to the neuronal deficits underlying HIV-associated
dementia.