SERIAL QUANTIFICATION OF THE HUMAN-IMMUNODEFICIENCY-VIRUS IN AN ARTHROSCOPIC EFFLUENT

We describe a case in which a patient infected with the human immunode ficiency virus (HIV) with high plasma viral titers underwent an arthro scopic partial meniscectomy allowing us the opportunity to measure the HIV titer of serial aliquots of the arthroscopic effluent using the p olymerase chain reaction. Two out of six aliquots were found to be HIV positive with 598 and 486 viral copies per milliliter noted. The plas ma viral load at the time of surgery was 149,000 copies per milliliter , whereas the prearthroscopy synovial fluid failed to show any detecta ble virus. This is the first report to our knowledge of HIV detected i n an arthroscopic effluent. The clinical implications for the arthrosc opist are also discussed.