Prognostic value of peripheral blood mononuclear cell-associated HIV-1 DNA for virological outcome in asymptomatic HIV-1 chronic infection.
BACKGROUND
Studies in primary HIV-1 infection and advanced HIV-1 disease have demonstrated that HIV-1 DNA associated with peripheral blood mononuclear cells (PBMC HIV-1 DNA) has predictive value for disease progression.


OBJECTIVE
To analyse in asymptomatic HIV-1 chronic infection the predictive value of PBMC HIV-1 DNA for virological failure.


METHODS
In 115 individuals who had previously participated in study STIR-2102, we retrospectively analysed the PBMC HIV-1 DNA by quantitative real-time PCR. Antiretroviral naïve patients (baseline pre-ART) received 6 weeks of ART prior to randomisation (baseline post-ART). The predictive value of PBMC HIV-1 DNA, HIV-1 RNA in plasma and CD4+ T cells, at baselines pre-ART and post-ART, was determined by Kaplan-Meier and Proportional Hazards Regression analyses.


RESULTS
At baseline post-ART, 82% of patients showed suppression of HIV-1 RNA, however they maintained significant amounts of HIV-1 DNA (geometric mean: 690 copies/10(6) PBMC). Pre-ART and post-ART levels of HIV-1 DNA and pre-ART levels of HIV-1 RNA showed predictive value (Log-Rank test: p<0.001, p<0.001, p=0.003, respectively). In a multivariate model post-ART PBMC HIV-1 DNA was the stronger predictive variable (adjusted HR, 2.51 [95% CI, 1.33-4.73, p=0.004]) independently of HIV-1 RNA (HR 1.74 [95% CI, 1.16-2.61, p=0.007]).


CONCLUSIONS
PBMC HIV-1 DNA is an effective prognostic marker for virological outcome in individuals with asymptomatic HIV-1 chronic infection.
Rodríguez-Sáinz
Carmen
C
Clinical Immunology Division, Hospital General Universitario Gregorio Marañón, Microbiology Department, Universidad Complutense de Madrid, Madrid, Spain. crodriguezs.hgugm@salud.madrid.org
Ramos
Ricardo
R
Valor
Lara
L
López
Francisco
F
Santamaría
Beatriz
B
Hernández
Diana C
DC
Cruz
Joana S P
JS
Navarro
Joaquín
J
Modrego
Jara
J
Alecsandru
Diana
D
Fernández-Cruz
Eduardo
E
D001769:Blood / Q000821:virology*; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification*; D015658:HIV Infections / Q000175:diagnosis / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome; D014773:Virology / Q000379:methods*
D004279:DNA, Viral; D012367:RNA, Viral