RELATIONSHIP BETWEEN LOAD OF VIRUS IN ALVEOLAR MACROPHAGES FROM HUMAN-IMMUNODEFICIENCY-VIRUS TYPE 1-INFECTED PERSONS, PRODUCTION OF CYTOKINES, AND CLINICAL STATUS

The level of human immunodeficiency virus type 1 (HIV-1) in lymphocyte s and mononuclear phagocytes (MP) from the blood and pulmonary alveoli from 14 HIV-1-infected subjects during early (asymptomatic) and late (AIDS) stages of disease and the relationship between virus burden in MP and cytokine expression were assessed. Among asymptomatic subjects, HIV-1 was undetectable or low in both blood monocytes and alveolar ma crophages (AM). Among subjects with AIDS, there was a significant incr ease of HIV-1 in AM but not monocytes. The level of HIV-1 in blood lym phocytes was higher than in either monocytes or AM. AM (but not monocy tes) expressed increased levels of lipopolysaccharide-stimulated cytok ine mRNA (tumor necrosis factor-alpha, interleukin-1beta, interleukin- 6) during both early and late stages of HIV-1 infection regardless of virus load. AM thus may serve as a reservoir for virus in late stages of disease yet contribute to the immunopathogenesis of lung disease in both early and late stages through increased cytokine expression.