Low HIV-1 proviral DNA burden detected by negative polymerase chain reaction in seropositive individuals correlates with slower disease progression.
During 1989, 316 members of a cohort of homosexual men were tested for HIV-specific DNA by the polymerase chain reaction (PCR) using a pair of gag-region primers. Of 125 HIV-seronegative subjects, 123 (98.4%) were PCR-negative while 158 (82.7%) of 191 HIV-seropositive subjects were PCR-positive. Fewer of the 33 subjects who were seropositive and PCR-negative were at Centers for Disease Control (CDC) stage IV than the seropositive, PCR-positive subjects (6 versus 25%; P = 0.030). The seropositive, PCR-negative group had higher mean CD4 counts (640 versus 490 x 10(6) cells/l; P = 0.006), higher CD4: CD8 ratios (0.92 versus 0.64; P = 0.004), lower immunoglobulin (Ig) G levels (1290 versus 1645 mg/dl; P = 0.002), lower IgA levels (168 versus 251 mg/dl; P less than 0.001), and lower C1q binding activity (8 versus 14%; P = 0.010) than the seropositive, PCR-positive subjects. The median rate of CD4 cell decline in the 3 years preceding the PCR sample was less marked in the seropositive, PCR-negative group than the seropositive, PCR-positive group (-58 versus -77 x 10(6) cells/l per year; P = 0.028). To control for duration of infection, we restricted the analysis to the subgroups of 11 seropositive, PCR-negative subjects and 34 seropositive, PCR-positive subjects who had seroconverted earlier in the cohort study. Both subgroups had similar durations of infection, yet the same pattern of differences persisted.(ABSTRACT TRUNCATED AT 250 WORDS)
Vancouver Lymphadenopathy-AIDS Study Group, Faculty of Medicine, University of British Columbia, Ottawa, Canada.
M T
MT
Schechter
P W
PW
Neumann
M S
MS
Weaver
J S
JS
Montaner
S A
SA
Cassol
T N
TN
Le
K J
KJ
Craib
M V
MV
O'Shaughnessy
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015922:Complement C1q / Q000276:immunology; D004279:DNA, Viral / Q000032:analysis*; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000235:genetics / Q000276:immunology* / Q000382:microbiology; D006679:HIV Seropositivity / Q000235:genetics / Q000276:immunology* / Q000382:microbiology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007136:Immunoglobulins / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
D004279:DNA, Viral; D015483:HIV Antibodies; D007136:Immunoglobulins; D015922:Complement C1q