The effect of acute infectious illnesses on plasma human immunodeficiency virus (HIV) type 1 load and the expression of serologic markers of immune activation among HIV-infected adults.
The effect of acute coinfections on plasma human immunodeficiency virus (HIV) load and immune activation markers was evaluated. Thirty-two HIV-infected persons were prospectively enrolled; 18 had pre-illness, acute, and follow-up specimens. Plasma HIV RNA levels were determined by reverse transcriptase-polymerase chain reaction, and serum levels of activation markers, including tumor necrosis factor (TNF)-alpha, soluble (s) TNF receptors (R)-I and -II, interleukin (IL)-2, IL-6, IL-10, sIL-2R, sCD4, and sCD8, were assessed by commercial ELISAs. Median plasma HIV load increased 7. 8-fold during illness (P=.001) and decreased 1.5-fold (P=.01) during convalescence (median, 15 days). Significant virus load reductions were limited to subjects with clinical recovery. By regression analysis, changes in plasma HIV RNA were significantly associated with changes in sTNFR-I, sTNFR-II, and sIL-2R. Increased HIV replication during acute coinfections is associated with in vivo immune activation, which underscores the need to prevent and promptly treat intercurrent illnesses.
Sulkowski
M S
MS
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Chaisson
R E
RE
Karp
C L
CL
Moore
R D
RD
Margolick
J B
JB
Quinn
T C
TC
D000208:Acute Disease; D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D018791:CD4 Lymphocyte Count; D003141:Communicable Diseases / Q000150:complications* / Q000821:virology; D003289:Convalescence; D016207:Cytokines / Q000097:blood*; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000821:virology*; D006801:Humans; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D015375:Receptors, Interleukin-2 / Q000097:blood; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D019562:Viral Load
D015703:Antigens, CD; D016207:Cytokines; D012367:RNA, Viral; D015375:Receptors, Interleukin-2; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha