High-level viremia in adults and children infected with human immunodeficiency virus: relation to disease stage and CD4+ lymphocyte levels.
Sixty-eight adults and nine children infected with human immunodeficiency virus type 1 (HIV-1) were evaluated consecutively for the presence and amount of cell-free infectious virus in their plasma. Viremia was detected in 18 of 68 adults and in five of nine children; titers ranged from 10 to 100,000,000 TCID/ml plasma. Among the adults, none of 19 asymptomatic patients, 4 of 34 AIDS-related complex patients, and 14 of 15 AIDS patients had cell-free infectious virus in their plasma. None of 35 adult subjects with CD4+ lymphocyte counts greater than 400/mm3 were viremic, whereas 3 of 17 with 200-400 CD4+ lymphocytes/mm3 and 15 of 16 individuals with less than 200 CD4+ lymphocytes/mm3 were plasma viremic. In contrast to adults, each of five children infected with HIV-1 in utero or during the perinatal period were plasma viremic regardless of their CD4+ lymphocytes counts (range, 42-2227/mm3), duration of infection, or clinical stage; however, children infected by HIV-1 at older ages were less frequently plasma viremic. Therapy with zidovudine led to a 10- to 10(6)-fold decline in plasma HIV-1 TCID in all eight subjects studied before and after treatment.
Department of Medicine, University of Alabama, Birmingham.
M S
MS
Saag
M J
MJ
Crain
W D
WD
Decker
S
S
Campbell-Hill
S
S
Robinson
W E
WE
Brown
M
M
Leuther
R J
RJ
Whitley
B H
BH
Hahn
G M
GM
Shaw
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D002648:Child; D015683:Gene Products, gag / Q000097:blood; D015483:HIV Antibodies / Q000097:blood; D015488:HIV Antigens / Q000097:blood; D016655:HIV Core Protein p24; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D015497:HIV-1 / Q000254:growth & development* / Q000302:isolation & purification; D006801:Humans; D007958:Leukocyte Count; D015203:Reproducibility of Results; D014758:Viral Core Proteins / Q000097:blood; D014766:Viremia / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D015215:Zidovudine / Q000627:therapeutic use
D015683:Gene Products, gag; D015483:HIV Antibodies; D015488:HIV Antigens; D016655:HIV Core Protein p24; D014758:Viral Core Proteins; D015215:Zidovudine