Transient high titers of HIV-1 in plasma and progression of disease.
Periodic quantitative HIV-1 plasma cultures were performed on 28 seropositive individuals who had CD4 cells < or = 300/mm3 and who were enrolled in three clinical trials testing the efficacy of didanosine versus zidovudine monotherapy. Most plasma cultures were negative or of low titer (1-100 tissue culture infective dose/ml of plasma), but there were 14 instances of high-titered plasma viremia (> or = 1,000 tissue culture infective dose/ml of plasma) seen in 11 individuals. These peaks in plasma culture titers were significantly associated either with rapidly decreasing CD4 cell numbers or with CD4 cells already < 50/mm3. In addition, patients who experienced these episodes of high-titered plasma viremia were more apt to have clinical complaints of fever, rash, flu-like illness, and/or opportunistic infection and also the syncytium-inducing HIV-1 phenotype and progression of disease.
Fiscus
S A
SA
Department of Microbiology and Immunology, University of North Carolina at Chapel Hill 27599, USA.
Heggem-Snow
A
A
Troiani
L
L
Wallmark
E
E
Folds
J D
JD
Sheff
B
B
van der Horst
C M
CM
D017088:AIDS-Related Opportunistic Infections / Q000150:complications; D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D004890:Erythema; D005260:Female; D005334:Fever; D015726:Giant Cells / Q000821:virology; D006679:HIV Seropositivity / Q000150:complications / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000821:virology*; D012189:Retrospective Studies; D014766:Viremia / Q000150:complications / Q000276:immunology / Q000821:virology*