Virologic and immunologic characterization of symptomatic and asymptomatic primary HIV-1 infection.
To define virologic and immunologic differences in patients with acute symptomatic and asymptomatic primary human immunodeficiency virus type 1 (HIV-1) infection, sequential plasma specimens were obtained longitudinally for 1-2 years postseroconversion from subjects with well-documented time of seroconversion. Thirteen of them had an acute symptomatic primary infection, eight subjects had asymptomatic primary infection and long-term follow-up, and 27 had asymptomatic seroconversion and short-term follow-up. Quantitative plasma HIV-1 RNA levels, CD4+ lymphocyte counts, and levels of antibodies to gp120, p66, p41, p31, p24, and p17 were measured. At the time of seroconversion, there was no significant difference in HIV-1 RNA levels and CD4+ counts between symptomatic (n = 13) and asymptomatic (n = 27) subjects. Subsequently, however, establishment of low levels of plasma HIV-1 RNA was seen significantly more frequently in asymptomatic (n = 8) than in symptomatic (n = 13) primary infection; this correlated with higher levels of some (anti-gp120 and anti-p31) anti-HIV-1 antibodies and a slower decline in CD4+ lymphocyte counts. These results indicate that immunologic control of viremia early after infection may be a critical determinant to subsequent clinical course of HIV-1 infection. They also suggest that persons with acute symptomatic primary infection may generally progress to having acquired immune deficiency syndrome (AIDS) more rapidly than people with low-grade symptoms or asymptomatic primary infection.
Henrard
D R
DR
Department of Medical Research, Abbott Laboratories, Abbott Park, Illinois, USA.
Daar
E
E
Farzadegan
H
H
Clark
S J
SJ
Phillips
J
J
Shaw
G M
GM
Busch
M P
MP
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000208:Acute Disease; D018791:CD4 Lymphocyte Count; D005260:Female; D015483:HIV Antibodies / Q000032:analysis; D015488:HIV Antigens / Q000276:immunology; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000276:immunology* / Q000821:virology
D015483:HIV Antibodies; D015488:HIV Antigens; D016655:HIV Core Protein p24; D012367:RNA, Viral