Transient high levels of viremia in patients with primary human immunodeficiency virus type 1 infection

Article Abstract:

When human immunodeficiency virus type 1 (HIV-1) enters the body (primary infection), the patient often experiences fever, muscle pains, and nausea or diarrhea, as well as developing a rash and, in some cases, neurologic problems. These symptoms may continue until antibody production begins (seroconversion), which may take days or even months. After seroconversion, the concentration (titer) of virus falls. Little is known concerning the course and biology of viral replication during the acute phase, a period during which the virus establishes itself in the body. Such information has important implications regarding the course of the disease, and its treatment. To learn more about this issue, blood was sampled sequentially from four male homosexual patients who became acutely ill with symptoms typical of HIV-1 infection. The samples were tested for their titers of p24 antigen (a component of the HIV-1 virus) and, using techniques of molecular biology, viral DNA obtained from infected blood cells was amplified (copied) to determine the extent of infection. Results are presented in graphical form for each patient showing the increase in antibody titer over time and the corresponding decline in the titers of viral particles and p24 antigen. The initial p24 concentrations were very high in all patients when they first came to the hospital, but declined within 7 to 12 days in three patients (samples were not obtained from the fourth during this time). Levels of HIV-1 were initially very high and fell spontaneously, without antiviral treatment, within days or weeks. One implication of these findings is that patients may have long periods when they test negative for HIV-1 antibodies, but are highly infectious. The results also suggest that the initial response of the host to HIV-1 infection is effective, causing rapid decreases in viral titer. More needs to be learned concerning the ways the virus overcomes this response and begins to replicate successfully again, later in the course of disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Development and progression, HIV infection, HIV infections, HIV patients

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Quantitation of human immunodeficiency virus type 1 in the blood of infected persons

Article Abstract:

The human immunodeficiency virus type 1 is the known causative agent of acquired immunodeficiency syndrome (AIDS). The infection can be detected by various means before any symptoms develop; the person is considered seropositive if the virus is detectable in the blood. When symptoms do develop, the infected patient usually passes through a period of incomplete development of the disease called AIDS-related complex, or ARC, before going on to exhibit all the manifestations of AIDS itself. The current study examined specific white blood cells for the level of virus particles that were present in serum taken from the blood of AIDS and ARC patients. These values were compared with those from both asymptomatic seropositive and seronegative individuals. The serum of all seropositive and none of the seronegative individuals contained detectable amounts of virus particles. Individuals who were seropositive but without symptoms had considerably lower quantities of virus in their plasma than either ARC or AIDS victims. Similar estimates were obtained of infected peripheral-blood mononuclear cells, a class of white blood cells, for all patient groups studied. Treatment with zidovudine (AZT) for four weeks reduced the amount of virus in plasma, but not in peripheral-blood mononuclear cells. A group of 20 patients receiving AZT in a long-term treatment plan had a 25-fold reduction in the level of virus in their blood plasma. The level of virus seen in this population is considerably higher than previous estimates, and suggests that the virus level by itself may be sufficient to induce many of the pathologic difficulties of this infection.

Evaluation, Diagnosis, Drug therapy, Identification and classification, AIDS (Disease), Zidovudine, AIDS-related complex

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HIV-1, HIV-2, and HTLV-I infection in high-risk groups in Brazil

Article Abstract:

The authors studied the blood of 704 Brazilians who were either known to have AIDS or to be at high risk for AIDS. In this study, the authors tested for antibodies to either the AIDS virus or to a related virus, Human T cell Leukemia Virus, HTLV. The study population included 70 homosexual males (11 of whom were prostitutes),58 bisexual males (including 19 of whom were prostitutes), 101 female prostitutes from various socioeconomic groups and from urban or rural locations, 13 wives of hemophiliacs who also demonstrated antibodies to HIV, and 47 blood donors who tested positive for syphilis. The rate of HIV (type I) infection was highest in the homosexual male prostitutes (45 percent), the wives of hemophiliacs (38 percent), bisexual men (28 percent), homosexual men who were not prostitutes (19 per cent) and lower-class female prostitutes (nine percent). Infection with HTLV ranged from one percent in rural female prostitutes to 13 per cent in the men with hemophilia. The authors conclude that in Brazil both the HIV and HTLV are well established within the groups studied and that bisexual men are probably responsible for the link between the heterosexual and homosexual populations.

Analysis, Medical examination, Brazil, Prostitutes, Gay men, Health surveys, Radioimmunoassay, HIV antibodies

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