Unintegrated circular HIV-1 DNA in the peripheral mononuclear cells of HIV-1-infected subjects: association with high levels of plasma HIV-1 RNA, rapid decline in CD4 count, and clinical progression to AIDS.

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Apr 1;17(4):303-13. Unique Identifier : AIDSLINE MED/98184342
Panther LA; Coombs RW; Zeh JE; Collier AC; Corey L; Department of Medicine, University of Washington, Seattle, USA.

Abstract: We observed 36 HIV-infected patients to evaluate whether the presence of tandem 2-long terminal repeat circular unintegrated HIV-1 DNA (2-LTR) in peripheral blood mononuclear cells (PBMC) at baseline was associated with acceleration of HIV disease. Detection of 2-LTR at baseline correlated with high plasma HIV-1 RNA levels (p < .01), recovery of culturable HIV-1 from plasma (p = .02), and progression to AIDS during follow-up (p = .01). More patients with 2-LTR (68%) than without 2-LTR (31%) had a decline in CD4 levels of >50 cells/mm3 over the first 18 months of follow-up (p = .04), and the average annual CD4 decline was 35% in patients with 2-LTR compared with 16% in those without 2-LTR p = 0.06). Detection of 2-LTR in PBMC at baseline was an independent predictor of high plasma HIV-1 RNA levels and subsequent CD4 cell decline in this cohort of patients with predominantly nonsyncytium-inducing (NSI) isolates at baseline. The presence of 2-LTR in PBMC appears to be reflective of ongoing HIV-1 replication, as measured by plasma HIV-1 RNA levels, and identifies persons at risk for immunologic and clinical decline.

Keywords: *DNA, Circular/BLOOD *DNA, Viral/BLOOD *HIV Infections/IMMUNOLOGY *HIV-1/PHYSIOLOGY *Leukocytes, Mononuclear/VIROLOGY *RNA, Viral/BLOOD
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M9861811

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