Journal Article

Residual Low-Level Viral Replication Could Explain Discrepancies between Viral Load and CD4<sup>+</sup> Cell Response in Human Immunodeficiency Virus—Infected Patients Receiving Antiretroviral Therapy

Felipe García, Carmen Vidal, Montserrat Plana, Anna Cruceta, M. Theresa Gallart, Tomas Pumarola, Jose M. Miro and Jose M. Gatell

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 2, pages 392-394
Published in print February 2000 | ISSN: 1058-4838
Published online February 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313660
Residual Low-Level Viral Replication Could Explain Discrepancies between Viral Load and CD4+ Cell Response in Human Immunodeficiency Virus—Infected Patients Receiving Antiretroviral Therapy

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We report the evolution of chronic infection with human immunodeficiency virus type 1 (HIV-1) in a patient treated with stavudine plus didanosine, whose CD4+ lymphocyte count progressively decreased, despite a sustained plasma viral load <20 copies/mL. After 12 months of therapy, treatment was switched to zidovudine plus lamivudine plus nelfinavir. CD4+ T cell count decreased from 559×106/L at month 0 to 259×106/L at month 12. Plasma viral load decreased from 21,665 HIV-1 RNA copies/mL at baseline (month 0) to <20 copies/mL after 1 month of therapy with stavudine plus didanosine, and remained below 20 copies/mL until month 12, but always >5 copies/mL. Viral load in tonsilar tissue at month 12 was 125,000 copies/mg of tissue. After the change to triple-drug therapy, the plasma viral load decreased to 5 copies/mL, the CD4+ T cell count increased to 705×106/L, and the viral load in tonsilar tissue decreased to <40 copies/mg of tissue at month 24. A low level of HIV-1 replication could explain the lack of immunologic response in patients with apparent virological response.

Journal Article.  2065 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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