title: Redistribution of HIV outside the lymphoid system with onset of AIDS.
abstract: The basis for many of the symptoms and pathological changes found in patients with the acquired immunodeficiency syndrome (AIDS) remains poorly understood. We have used a quantitative polymerase chain reaction technique to investigate the extent to which direct infection with human immunodeficiency virus (HIV) produces the disease manifestations of AIDS. In five patients who died with AIDS-defining illnesses (Centers for Disease Control and Prevention class IV), we found variable, but in many cases extensive, infection by HIV at various sites, including brain, lung, colon, and liver. By contrast, in three HIV-positive subjects who died without HIV-related disease (CDC class II), we found no evidence of significant infection of any non-lymphoid organ. In both groups of patients there were high levels of infection in cells of the spleen, lymph nodes, and peripheral blood. Pathological examination of tissues from the AIDS patients revealed many abnormalities, of which some, such as giant-cell encephalitis in the brain, were specifically associated with the presence of high levels of HIV infection. These findings suggest that spread of HIV outside cells of the immune system is a late event in HIV infection and is extremely sensitive to the degree of immunosuppression in the patient.
authors.affiliation: Department of Medical Microbiology, University of Edinburgh, UK.
authors.forename: Y K
authors.initials: YK
authors.lastname: Donaldson
authors.forename: J E
authors.initials: JE
authors.lastname: Bell
authors.forename: J W
authors.initials: JW
authors.lastname: Ironside
authors.forename: R P
authors.initials: RP
authors.lastname: Brettle
authors.forename: J R
authors.initials: JR
authors.lastname: Robertson
authors.forename: A
authors.initials: A
authors.lastname: Busuttil
authors.forename: P
authors.initials: P
authors.lastname: Simmonds
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000382:microbiology*; D000328:Adult; D001483:Base Sequence; D001921:Brain / Q000382:microbiology; D003106:Colon / Q000382:microbiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006679:HIV Seropositivity / Q000382:microbiology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000382:microbiology; D008168:Lung / Q000382:microbiology; D008208:Lymphatic System / Q000382:microbiology; D008297:Male; D008969:Molecular Sequence Data
chemical_list: D004279:DNA, Viral