VIREMIA QUANTIFICATION IN PATIENTS WITH T HE HUMAN-IMMUNODEFICIENCY-VIRUS WITH RAPID AND SLOW DISEASE PROGRESSION

BACKGROUND: The natural course of the human immunodeficiency virus typ e 1 (HIV-1) infection is very variable. The factors which appear to de termine the speed of immunodeficiency progression are multiple, althou gh the virulence of the predominant vial strain seems to be one the ma in factors. The plasmatic viremia in individuals with rapid and slow H IV-1 progression was analyzed in an attempt to establish the degree of correlation between HIV-1 replication and the natural course of the d isease. METHODS: Forty-two samples from 34 seropositive patients, 11 w ith rapid progression criteria (< 5 years from acute infection and CD4 + lymphocytes < 0.2 x 10(9)/l) and 23 with slow progression (> 7 years from demonstrated infection and > 0.5 x 10(9) CD4+ lymphocytes/l) wer e studied. The plasmatic viremia was quantified by a new method of pla sma DNA genetic amplification, denominated the branched DNA (bDNA) tec hnique. As a reference circulating p24 was determined and the presence of several proviral regions were studied in peripheral blood lymphocy tes by polymerase chain reaction (PCR). RESULTS: The presence of RNA m olecules was detected in plasma of 7 (58.3%) out of 12 samples of rapi d progression (RP) patients by bDNA. To the contrary, this was negativ e in 30 samples from slow progression (SP) patients. Four of the 5 neg ative RP samples corresponded to patients who had taken antiretroviral drugs at the time of the study. The p24 antigenemia was positive in 5 (41.6%) from the RP patients and in none of the SP patients. The pres ence of gag, pol and env sequences was positive by PCR in all RP patie nts and in most of the SP patients. However, repeatedly negative resul ts by PCR were observed in 5 SP samples for all or some of the genomic regions studied. CONCLUSIONS: Patients with rapid progression of HIV- 1 have higher plasmatic viremia than subjects with slow disease progre ssion.