Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy.

Content Provider	Semantic Scholar
Author	Dornadula, Geethanjali Zhang, Hui Uitert, B. Van Stern, John Livornese, L. L. Ingerman, M. J. Witek, James Kedanis, R. J. Natkin, J. Desimone, Joseph
Copyright Year	1999
Abstract	CONTEXT Despite suppressive treatment with highly active antiretroviral therapy (HAART), replication-competent virus can still be isolated from peripheral blood mononuclear cells and genital cells of many individuals receiving suppressive HAART. OBJECTIVE To determine whether free virion RNA can be detected in the blood plasma and/or genital tract fluids from patients receiving suppressive HAART. DESIGN Prospective cohort study conducted from November 1998 to May 1999. SETTING Academic medical center. PATIENTS Human immunodeficiency virus 1-infected individuals (20 men and 2 women) shown in our laboratories to have fewer than 50 copies/mL of HIV-1 RNA in peripheral blood plasma while taking suppressive HAART. MAIN OUTCOME MEASURES Free virion RNA levels in peripheral blood plasma and genital fluids, quantified using an ultrasensitive reverse transcriptase polymerase chain reaction able to quantify cell-free virion RNA to a lower limit of 5 copies/mL and qualitatively detect viral RNA below this level. RESULTS In all 22 patients, residual viral RNA could be detected in the peripheral blood plasma (mean level, 17 copies/mL). The presence of viral RNA suggests that ongoing viral replication is occurring, albeit at low levels, in each patient evaluated. Viral RNA levels were lower in most patients' genital fluids compared with blood plasma and in 12 patients were undetectable. CONCLUSIONS These data suggest that low-level replication of HIV-1 in patients taking suppressive HAART may be demonstrated not only in peripheral blood mononuclear cells but also in peripheral plasma as cell-free virion RNA. Complete ablation of viral replication may require intensification of antiretroviral therapies beyond standard suppressive HAART.
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Alternate Webpage(s)	http://jama.jamanetwork.com/pdfaccess.ashx?url=/data/journals/jama/4710/joc91532.pdf
PubMed reference number	10553788v1
Volume Number	282
Issue Number	17
Journal	JAMA
Language	English
Access Restriction	Open
Subject Keyword	Antiretroviral Therapy, Highly Active Antiretroviral therapy Copy (object) HIV Infections Hematological Disease Immunologic Deficiency Syndromes Laboratory Liquid substance Patients Peripheral Neuropathy Peripheral blood mononuclear cell (cell) Plasma RNA RNA-Directed DNA Polymerase Reverse Transcriptase Polymerase Chain Reaction Virus Replication viral capsid secondary envelopment
Content Type	Text
Resource Type	Article