RESIDUAL HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 RNA IN LYMPHOID-TISSUE OF PATIENTS WITH SUSTAINED PLASMA RNA OF LESS-THAN-200 COPIES ML/

Human immunodeficiency virus type 1 (HIV-1) RNA was measured in lymph node (LN) mononuclear cells of 50 patients with sustained plasma RNA o f <200 copies/mL with therapy. Six patients had received a combination of three reverse transcriptase inhibitors (RTIs) since primary infect ion, 11 received this same combination during chronic disease, 21 rece ived a combination of two RTIs plus a protease inhibitor (PI), and 12 received three RTIs plus a PI. The mean overall duration of therapy wa s 8.9 +/- 0.5 months (range, 5-24), with no significant difference bet ween groups, LN HIV-1 RNA levels varied from undetectable to 1.7 milli on copies/10(6) cells according to cases. The mean LN HIV-1 RNA level was 2.99 +/- 0.42 log(10) copies/10(6) cells in the 17 patients receiv ing three RTIs compared with 1.93 +/- 0.25 log(10) copies/10(6) cells in the 33 patients receiving a PI (t test, P = .02), These data demons trate that highly active antiretroviral regimens have unequivalent eff ects on LNs and invite redefinition of suboptimal therapy at this leve l.