title: Effect of highly active antiretroviral therapy on viral burden in the lungs of HIV-infected subjects.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) is readily detectable in the lungs of infected subjects and leads to an accumulation of CD8(+) lymphocytes in the alveolar space. Although highly active antiretroviral therapy (HAART) is effective in reducing viremia, less is known about its effect on tissue compartments. The AIDS Clinical Trials Group Protocol 723 Team evaluated the effect of HAART on lung viral load and cellular constituents.
  
  
  METHODS
  Bronchoalveolar lavage (BAL) fluid and blood were collected before initiation of HAART and again at 4 and 24 weeks after initiation of therapy. The BAL cell differential was determined, lymphocyte phenotyping was performed, and acellular BAL fluid, plasma HIV RNA load, and BAL cell and peripheral blood mononuclear cell HIV RNA and DNA loads were measured.
  
  
  RESULTS
  HAART induced a rapid decrease in HIV that was detectable in acellular BAL fluid and a slower decrease in the HIV RNA and DNA loads in BAL cells. HAART was associated with a significant decrease in the absolute number and percentage of CD8(+) alveolar lymphocytes. There was a significant correlation between residual BAL cell DNA at 24 weeks and the absolute number of CD4(+) lymphocytes in the alveolar space.
  
  
  CONCLUSIONS
  HAART is associated with a significant decrease in the pulmonary HIV burden and a return of alveolar cellular constituents to normal.
authors.affiliation: Division of Pulmonary and Critical Care Medicine and the AIDS Clinical Trials Unit, Indiana University Medical Center, Indianapolis, USA. htwig@iupui.edu
authors.forename: Homer L
authors.initials: HL
authors.lastname: Twigg Iii
authors.forename: Michael
authors.initials: M
authors.lastname: Weiden
authors.forename: Fred
authors.initials: F
authors.lastname: Valentine
authors.forename: Carol T
authors.initials: CT
authors.lastname: Schnizlein-Bick
authors.forename: Roland
authors.initials: R
authors.lastname: Bassett
authors.forename: Lu
authors.initials: L
authors.lastname: Zheng
authors.forename: Joseph
authors.initials: J
authors.lastname: Wheat
authors.forename: Richard B
authors.initials: RB
authors.lastname: Day
authors.forename: Helen
authors.initials: H
authors.lastname: Rominger
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Collman
authors.forename: Lawrence
authors.initials: L
authors.lastname: Fox
authors.forename: Barbara
authors.initials: B
authors.lastname: Brizz
authors.forename: Joan
authors.initials: J
authors.lastname: Dragavon
authors.forename: Robert W
authors.initials: RW
authors.lastname: Coombs
authors.forename: R Pat
authors.initials: RP
authors.lastname: Bucy
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000821:virology; D004279:DNA, Viral / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000187:drug effects* / Q000821:virology*; D008297:Male; D011650:Pulmonary Alveoli / Q000187:drug effects / Q000821:virology; D012367:RNA, Viral / Q000187:drug effects; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral