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To determine which markers of human immunodeficiency virus type 1 (HIV) replication correlate most closely with progressive disease, we compared the following: (1) the frequency of isolation of HIV from peripheral-blood mononuclear cells (PBMC), (2) the frequency of isolation of the virus from cell-free plasma (plasma viremia), (3) the presence and titer of p24 antigen in plasma, and (4) the presence and titer of antibody to p24 antigen. We studied 213 persons who were positive for HIV antibody and 71 who were negative. HIV was isolated from PBMC from 207 of the 213 antibody-positive patients (97 percent), regardless of the clinical stage of the infection. Plasma viremia, in contrast, was correlated with the clinical stage of the infection. It was detected in 11 of 48 patients (23 percent) with asymptomatic infection, 32 of 71 (45 percent) in Class IVa of the Centers for Disease Control (those with AIDS-related complex), and 75 of 92 (82 percent) in Class IVc (those with AIDS) (P less than 0.01). Plasma HIV titers ranged from 10(0) to 10(4.3) and rose from a mean of 10(1.4) in asymptomatic patients to 10(2.5) in those with AIDS (P less than 0.02). Only 45 percent of patients with plasma viremia had HIV p24 antigen in either serum or plasma, and no correlation was found between the amount of p24 antigen in plasma and the plasma HIV titers. Follow-up tests indicated that plasma viremia was associated with a more marked decline in the CD4-lymphocyte cell count and the development of symptomatic disease (P = 0.034). We conclude that plasma viremia is a more sensitive virologic marker of the clinical stage of HIV infection and viral replication than the presence of p24 antigen or antibody in plasma. Not only whole blood but cell-free plasma from HIV-infected patients should be considered potentially infectious.
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
January 1992,
Journal of acquired immune deficiency syndromes,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
January 1997,
Journal of virology,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
April 1997,
The Pediatric infectious disease journal,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
October 2007,
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
May 1993,
The Journal of infectious diseases,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
January 1980,
American journal of veterinary research,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
February 1993,
Journal of clinical microbiology,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
January 2014,
PloS one,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
April 1999,
Virology,
R W Coombs, and
A C Collier, and
J P Allain, and
B Nikora, and
M Leuther, and
G F Gjerset, and
L Corey
January 1999,
Viral immunology,
