Virological and immunological profiles among patients with undetectable viral load followed prospectively for 24 months.
OBJECTIVE
To quantify HIV-RNA in plasma, in lymphoid tissue and proviral DNA in peripheral blood mononuclear cells and to relate these to immunological markers among patients with plasma viral load counts of </= 200 HIV-RNA copies/mL.


METHODS
A prospective study of one hundred and three patients was undertaken with an inclusion criteria of plasma viral load of </= 200 copies/mL. The patients had advanced HIV infection; 25% had developed AIDS. Patients were seen every 6 months for a period of 2 years.


RESULTS
The median plasma viral load was < 20 copies/mL with no increase during follow-up. Thirty-one per cent had plasma viral load of </= 20 copies/mL at all visits, 44% had >/= 1 measurement with 21-200 and 25% had >/= 1 sample with plasma HIV-RNA > 200 copies/mL. Lymphoid tissue viral load was low at enrolment and declined further during follow-up. Baseline HIV-DNA and immunoglobulin (IgA) differed significantly between the plasma viral load rebound groups (P < 0.05).


CONCLUSIONS
In this cohort, selected solely on the basis of having a plasma viral load of </= 200 copies/mL, we found stable or declining viral loads in the measured compartments during 2 years of follow-up. Baseline HIV-DNA and IgA levels were higher among patients with less complete virological suppression relative to patients with persistently undetectable plasma HIV-RNA. Hence, a high cellular level of HIV-DNA and high plasma IgA may predict subsequent development of low-grade viraemia.
Katzenstein
T L
TL
Departments of Infectious Diseases and Clinical Immunology, Rigshospitalet, Copenhagen, Denmark. Katzenstein@dadlnet.dk
Ullum
H
H
Røge
B T
BT
Wandall
J
J
Dickmeiss
E
E
Barrington
T
T
Skinhøj
P
P
Gerstoft
J
J
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008221:Lymphoid Tissue / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011533:Proviruses / Q000302:isolation & purification; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load; D014766:Viremia / Q000276:immunology / Q000821:virology
D019380:Anti-HIV Agents; D004279:DNA, Viral; D007070:Immunoglobulin A; D012367:RNA, Viral