Virological and immunological profiles among patients with undetectable viral load followed prospectively for 24 months

Abstract

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.

2B4 expression on natural killer cells increases in HIV-1 infected patients followed prospectively during highly active antiretroviral therapy

“…The initial antiretroviral therapy prior to HAART consisted of one, two, three or four drugs in 38, 24, 34 and five patients [30]. At inclusion, most patients received protease inhibitor (PI)‐based therapy with three ( n = 82) or four drugs ( n = 18) and six patients also received a non‐nucleoside reverse transcriptase inhibitor (NNRTI).…”

“…The present study was carried out at the Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark as described previously [30]. In the period September 1997–August 1998, 101 patients with reproducible plasma HIV‐RNA ≤ 200 copies/ml were included and followed prospectively for 24 months (Table 1).…”

“…Samples yielding a signal ≥ twice that of the mean of numerous negative controls were recorded as detectable but non‐quantifiable (D‐NQ) while samples with weaker signals were recorded as undetectable (UD). For statistical analysis, D‐NQ and UD samples were given values of 20 and 19 copies/ml, respectively [30]. Proviral HIV DNA copies/10 6 PBMC (proviral‐DNA) were quantified with a prototype assay (Amplicor HIV DNA assay, Roche Diagnostic Systems Inc., Branchburg, NJ, USA) according to the manufacturer's recommendations, as described previously [30].…”

T Cell Subsets in HIV Infected Patients after Successful Combination Antiretroviral Therapy: Impact on Survival after 12 Years

“…This group of well treated patients underwent repetitive extensive immunological examinations at regular intervals for the first 24 months of treatment [15]–[19]. For the purpose of this study baseline was defined as the date of immunological evaluation done 18 months (+/−6 months) after cART initiation, which was the time point where most patients were represented.…”

“…All immunological and virological methods have been described in greater detail elsewhere [20], [21].…”