CORRELATION BETWEEN PLASMA HIV-1 RNA LEVELS AND THE RATE OF IMMUNOLOGICAL DECLINE

To determine the influence of HIV-1 replication on immunologic decline and clinical outcome, we quantified the HIV-1 plasma viral load in 20 patients at different times over a mean period of 10.8 months. Quanti tation was performed by branched DNA signal amplification (bDNA) and p 24 antigenemia. immunologic status was assessed through beta(2)-microg lobulin and CD4(+) cell count determinations. CD4(+) cell decline was expressed as a slope of the regression line constructed by the logarit hms of CD4(+) cell count observations. Mean values of plasma viral loa d were correlated with CD4(+) cell decline and mean beta(2)-microglobu lin levels. Significant correlation was observed between plasma viral load quantified by the bDNA technique and CD4(+) cell decline. No sign ificant correlation was observed between plasma viral load quantified by p24 antigenemia and CD3(+) cell decline. A significant correlation was observed between plasma viral load and beta(2)-microglobulin level s. Immunologic decline was better predicted from HIV-1 RNA levels than from the CD4(+) cell count. Significantly higher plasma viral load wa s observed in patients who had clinical progression of HIV-1 infection . Thus, HIV-1 plasma viral load quantified by a highly reliable techni que such as bDNA showed that the immunologic decline is closely relate d to HIV-1 RNA replication.