HIV RNA and HIV DNA in peripheral blood mononuclear cells are consistent markers for estimating viral load in patients undergoing long-term potent treatment

The aim of this study was to evaluate residual viral replication by assessi ng the HIV load of circulating infected cells in patients given an effectiv e antiprotease-containing treatment for 1 year. PBMC HIV RNA and HIV DNA wa s quantified by techniques standardized and evaluated by interlaboratory qu ality control testing. Viral markers identified in a multicenter study were validated in a cross-sectional study of 121 patients beginning treatment. A longitudinal study of 3 viral markers was carried out in 18 patients, eac h of whom had fewer than 200 copies of HIV RNA per milliliter of plasma aft er 12 months of treatment. The cross-sectional study showed that viral repl ication in PBMCs was correlated with the number of circulating infected cel ls (Spearman rank correlation; p = 0.0001, r = 0.35) and the concentration of virus particles in the plasma (Spearman; p = 0.0001, r = 0.54). The long itudinal study showed that the decrease in HIV RNA levels was smaller in PB MCs than in the plasma. The largest decrease in HIV DNA levels after 12 mon ths of treatment was recorded in patients with low levels of intracellular replication (Spearman; p = 0.005, r = 0.69). PBMC HIV RNA and HIV DNA level s were very informative markers, complementary to plasma HIV RNA levels. Th ey should be used in future trials evaluating the long-term efficacy of new associations of highly active antiretroviral treatments.