QUANTITATION OF VIREMIA IN PATIENTS INFEC TED WITH HUMAN-IMMUNODEFICIENCY-VIRUS WITH DIFFERENT DEGREES OF IMMUNOSUPPRESSION

Background. Many of the therapeutical decisions related to patients in fected with human immunodeficiency virus (HIV) are taken considering t he CD4+ lymphocyte count. The recent availability of procedures which quantitate the number of viral particles in peripheral blood has discl osed that viremia degree is the beet predictor of HIV disease progress ion. Nevertheless, the proportion of subjects who despite a normal CD4 + lymphocyte count, have a high viremia and a high risk of short term progression to AIDS is not well known. Patients and methods. Plasma vi remia was investigated in 120 adults subjects with a known time of HIV infection. Fifty-two patients had a CD4+ lymphocyte count > 500 x 10( 6)/l (CDC group 1), 42 had a number of CD4+ lymphocytes ranging from 2 00 and 500 x 10(6)/l (CDC group 2), and 26 had a count < 200 x 10(6)/l (CDC group 3). None of the patients was receiving antiretroviral trea tment or had intercurrent infections at the time of the study. Results . Mean values of viremia showed an inverse significant relationship wi th the CD4+ lymphocyte count. In CDC group 1 subjects the distribution of viremia was as follows: low (< 3,000 copies of HIV RNA/ml) in 16 ( 30.8%), intermediate in 20 (38.4%), and high (> 30,000 copies of HIV R NA/ml) in 16 (30.8%). In eight subjects from CDC group 1, the duration of HIV infection was less than 5 years. In contrast, in patients from CDC group 3, viremia was high in 17 (65.4%), intermediate in 9 (34.6% ), and none of them had a low degree viremia. In CDC group 2 patients, viremia was high in 14 (33.3%), intermediate in 20 (47.6%), and low i n 8 (19.1%). Conclusion. There is an inverse correlation between the v iremia degree and the CD4+ lymphocyte count among HIV-positive patient s. Nevertheless, there can be a high viremia in absence of low CD4+ ly mphocyte count, particularly among subjects with HIV infection for les s than 5 years, in whom an early therapeutical intervention might be w arranted.