A SIMPLIFIED METHOD FOR QUANTITATION OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 (HIV-1) RNA IN PLASMA - CLINICAL CORRELATES

Human immunodeficiency virus type 1 (HIV1) RNA was quantitated in the plasma of HIV1-seropositive patients using a simplified guanidinium-ba sed extraction technique, reverse transcriptase (RT) and the polymeras e chain reaction (PCR). Plasma samples were obtained from 15 HIV1-sero negative individuals and 38 HIV1-seropositive patients. Following the extraction of RNA from plasma using ''RNAzol'', HIV1 RNA was reverse-t ranscribed using random hexamers, amplified by PCR and then detected b y solution oligonucleotide hybridization. Of the 15 HIV1-seronegative individuals, 14 were negative for HIV1 RNA by RT-PCR. One high-risk pa tient who was HTLV-1-seropositive but HIV1-seronegative was found to b e positive for HIV1 RNA by RT-PCR. All 38 HIV1-seropositive patients w ere positive for HIV1 RNA by this technique. The HIV1 RNA levels in pl asma varied from 800 to 500,000 copies/ml. Patients with advanced clin ical disease tended to have HIV1 RNA levels above 25,000 copies/ml. In patients studied serially, an increase in plasma HIV1 RNA correlated with a progressive decline in CD4(+) T cells and a deteriorating clini cal course. The simplified quantitative RT-PCR assay for HIV1 RNA prov ides a useful tool for the evaluation and management of HIV disease.