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Virological and immunological profiles among patients with undetectable viral load followed prospectively for 24 months
Author(s) -
Katzenstein TL,
Ullum H,
Røge BT,
Wandall J,
Dickmeiss E,
Barrington T,
Skinhøj P,
Gerstoft J
Publication year - 2003
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1046/j.1468-1293.2003.00119.x
Subject(s) - viral load , medicine , prospective cohort study , peripheral blood mononuclear cell , immunology , human immunodeficiency virus (hiv) , rna , virology , biology , in vitro , gene , biochemistry
Objective To quantify HIV‐RNA in plasma, in lymphoid tissue and proviral DNA in peripheral blood mononuclear cells and to relate these to immunological markers among patients with plasma viral load counts of ≤ 200 HIV‐RNA copies/mL. Methods A prospective study of one hundred and three patients was undertaken with an inclusion criteria of plasma viral load of ≤ 200 copies/mL. The patients had advanced HIV infection; 25% had developed AIDS. Patients were seen every 6 months for a period of 2 years. Results The median plasma viral load was < 20 copies/mL with no increase during follow‐up. Thirty‐one per cent had plasma viral load of ≤ 20 copies/mL at all visits, 44% had ≥ 1 measurement with 21–200 and 25% had ≥ 1 sample with plasma HIV‐RNA > 200 copies/mL. Lymphoid tissue viral load was low at enrolment and declined further during follow‐up. Baseline HIV‐DNA and immunoglobulin (IgA) differed significantly between the plasma viral load rebound groups ( P < 0.05). Conclusion In this cohort, selected solely on the basis of having a plasma viral load of ≤ 200 copies/mL, we found stable or declining viral loads in the measured compartments during 2 years of follow‐up. Baseline HIV‐DNA and IgA levels were higher among patients with less complete virological suppression relative to patients with persistently undetectable plasma HIV‐RNA. Hence, a high cellular level of HIV‐DNA and high plasma IgA may predict subsequent development of low‐grade viraemia.