Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy
| Autor: | Mark J. Ingerman, Joseph A. DeSimone, Roger J. Pomerantz, Richard J. Kedanis, James Witek, Bonnie VanUitert, John M. Stern, Hui Zhang, Geethanjali Dornadula, Jaan Natkin, Lawrence Livornese |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Anti-HIV Agents HIV Infections Virus Replication Peripheral blood mononuclear cell Semen Blood plasma Medicine Humans Prospective Studies biology business.industry Reverse Transcriptase Polymerase Chain Reaction RNA RNA virus General Medicine biology.organism_classification Virology Reverse transcriptase Body Fluids Viral replication Lentivirus Immunology Vagina HIV-1 RNA Viral Drug Therapy Combination Female business Viral load |
| Zdroj: | JAMA. 282(17) |
| ISSN: | 0098-7484 |
| Popis: | ContextDespite suppressive treatment with highly active antiretroviral therapy (HAART), replication-competent virus can still be isolated from peripheral blood mononuclear cells and genital cells of many individuals receiving suppressive HAART.ObjectiveTo determine whether free virion RNA can be detected in the blood plasma and/or genital tract fluids from patients receiving suppressive HAART.DesignProspective cohort study conducted from November 1998 to May 1999.SettingAcademic medical center.PatientsHuman immunodeficiency virus 1–infected individuals (20 men and 2 women) shown in our laboratories to have fewer than 50 copies/mL of HIV-1 RNA in peripheral blood plasma while taking suppressive HAART.Main Outcome MeasuresFree virion RNA levels in peripheral blood plasma and genital fluids, quantified using an ultrasensitive reverse transcriptase polymerase chain reaction able to quantify cell-free virion RNA to a lower limit of 5 copies/mL and qualitatively detect viral RNA below this level.ResultsIn all 22 patients, residual viral RNA could be detected in the peripheral blood plasma (mean level, 17 copies/mL). The presence of viral RNA suggests that ongoing viral replication is occurring, albeit at low levels, in each patient evaluated. Viral RNA levels were lower in most patients' genital fluids compared with blood plasma and in 12 patients were undetectable.ConclusionsThese data suggest that low-level replication of HIV-1 in patients taking suppressive HAART may be demonstrated not only in peripheral blood mononuclear cells but also in peripheral plasma as cell-free virion RNA. Complete ablation of viral replication may require intensification of antiretroviral therapies beyond standard suppressive HAART. |
| Databáze: | OpenAIRE |
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