The epidemiology of HIV-1 infection of the lung in AIDS patients.
OBJECTIVE
To examine the relationship between HIV-1 infection of cells obtained by bronchoalveolar lavage (BAL) from the lung and the pathogenesis of AIDS.


METHODS
Prospective study of 121 consecutive HIV-1-seropositive patients undergoing investigation for respiratory symptoms or abnormal chest radiograph.


METHODS
Polymerase chain reaction (PCR) for the detection of HIV-1-specific proviral DNA. Cocultivation of leukocytes obtained from BAL with donor cord blood leukocytes (CBL) to isolate HIV-1.


RESULTS
HIV-1 was detected by PCR in the lung cells of 78 out of 121 (65%) patients. It was detected in 55% of patients who had been seropositive for less than 1 year, but in over 80% of patients who had been seropositive for more than 3 years. HIV-1 was isolated from 61 out of 106 (58%) individuals. The ability to detect or isolate HIV-1 from the lung correlated directly to CD4 cell count in peripheral blood. HIV-1 was detected significantly more frequently in the BAL cells of smokers compared with non-smokers (P = 0.01).


CONCLUSIONS
HIV-1 was frequently detected and isolated from the lung of AIDS patients undergoing a respiratory episode. HIV-1 infection of the lung became more frequent with time from serodiagnosis. Patients who smoked were more likely to succumb to HIV-1 infiltration into the lung and HIV-1 infection of the lung was associated with progression to death.
Clarke
J R
JR
Department of Medical Microbiology, St Mary's Hospital Medical School, London, UK.
Taylor
I K
IK
Fleming
J
J
Nukuna
A
A
Williamson
J D
JD
Mitchell
D M
DM
D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007958:Leukocyte Count; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects; D015215:Zidovudine / Q000627:therapeutic use
D015215:Zidovudine