Role of HIV-1 phenotype in viral pathogenesis and its relation to viral load and CD4+ T-cell count.
The predictive value of HIV-1 phenotype in peripheral blood mononuclear cell (PBMC) coculture and the relation among viral phenotype, viral load, and CD4+ T-cell count were examined in two studies. In study A, 132 HIV-1-infected individuals were examined retrospectively for the relation between the result of their initial HIV cultivation in PBMC coculture and survival rate 6 years later. In study B, 176 patients were examined since 1994 for markers of HIV disease progression. HIV-1 phenotype was determined by PBMC cocultivation, viral load by NASBA HIV RNA QT System, and CD4+ T-cell count by flow cytometry. In study A, the percentage of survival for patients with initial negative virus culture was significantly higher (95%) than in patients with nonsyncytia-inducing (NSI) isolates (78%) and syncytia-inducing (SI) isolates (21%) (P < 0.05 and P< 0.0001, respectively). When SI phenotype was subdivided into moderately cytopathogenic and highly cytopathogenic, significant differences in the rate of survival between these subgroups could be observed (45% vs. 14%; P < 0.05). In study B, progression from negative virus culture to the isolation of NSI variants was associated with increasing viral load (P < 0.0001) but did not affect CD4+ T-cell count significantly (P> 0.07), whereas the switch from NSI to SI virus was accompanied by significant decline of CD4+ T-cells (P < 0.0001) but no change in viral load (P > 0.21). Thus, isolation and phenotyping of HIV represents an additional striking predictive marker for progression of HIV infection.
Institute of Medical Microbiology and Immunology, University of Bonn, Germany.
B
B
Kupfer
R
R
Kaiser
J K
JK
Rockstroh
B
B
Matz
K E
KE
Schneweis
D018791:CD4 Lymphocyte Count; D002478:Cells, Cultured; D018920:Coculture Techniques; D015331:Cohort Studies; D003588:Cytopathogenic Effect, Viral; D018450:Disease Progression; D015658:HIV Infections / Q000276:immunology / Q000401:mortality / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification / Q000472:pathogenicity* / Q000502:physiology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology; D008137:Longitudinal Studies; D010641:Phenotype; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D015996:Survival Rate; D019562:Viral Load; D014776:Virus Cultivation
D012367:RNA, Viral