High levels of circulating RNA in patients with symptomatic HIV-1 infection.
OBJECTIVE
To evaluate the concentration of circulating RNA (viraemia) in patients with symptomatic primary HIV infection and relate it to sero-immunological parameters.


METHODS
Semiquantitation of circulating HIV RNA and proviral HIV DNA was performed using the polymerase chain reaction. Circulating HIV RNA concentrations were expressed as virus equivalent (RNA copies/2) per ml serum.


RESULTS
The mean CD4+ lymphocyte count for 19 patients with symptomatic primary HIV infection was 583 x 10(6)/l. Fifteen (79%) patients had detectable levels of p24 antigen (median 462 pg/ml). Circulating HIV RNA (median 2.3 x 10(7) virus equivalent/ml serum) and proviral HIV DNA (median 3630 copies/ml blood) were detected in all samples tested. Follow-up data for five patients (200-1600 days) showed a 1-3 log reduction in circulating RNA within 2 months. Later, circulating RNA concentrations were consistently greater than 10(3) virus equivalent/ml serum. Within 10 days no p24 antigen was detectable. Levels of CD4+ cells varied markedly from patient to patient during the follow-up and, in this small group, no evident correlation was observed between circulating RNA levels and CD4+ lymphocyte counts.


CONCLUSIONS
High concentrations of circulating RNA (viraemia) were present in 19 patients with symptomatic primary HIV infection. Although a decrease in viraemia was observed during the following 2 months, viraemia persisted in all patients with long-term follow-up. This suggests that active viral replication is a continuous process in HIV-infected patients.
Baumberger
C
C
Central Laboratory of Virology, Geneva University Hospital, Switzerland.
Kinloch-de-Loës
S
S
Yerly
S
S
Hirschel
B
B
Perrin
L
L
D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000276:immunology / Q000382:microbiology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000706:statistics & numerical data; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification; D012367:RNA, Viral / Q000097:blood* / Q000235:genetics; D015203:Reproducibility of Results; D013997:Time Factors; D014766:Viremia / Q000097:blood / Q000276:immunology / Q000382:microbiology*; D014779:Virus Replication
D004279:DNA, Viral; D012367:RNA, Viral