Dynamics of viral load in plasma and HIV DNA in lymphocytes during highly active antiretroviral therapy (HAART): High viral burden in macrophages after 1 year of treatment

In this study we evaluated the level of HIV RNA in plasma and HIV DNA in pe ripheral blood cells. Sixteen antiretroviral-experienced HIV patients with severe immune suppression were included in the study. After the first month , 56.2% of the patients showed undetectable levels of HIV RNA, this percent age remaining stable after 1 year (53.3%). At enrollment, 7 patients (43.7% ) with a low CD4+T cell count (mean 22 per mm(3) versus 73) showed HIV DNA levels below the limit of detection (5 copies/10(5)) in lymphocytes. They a ll subsequently had increased HIV DNA that became detectable between the fi rst and the third month of therapy, associated with an increase of the CD4T cell count (mean 22 to 95 / mm(3)); in 4 of these patients this increase was transitory, becoming undetectable again after one year. In 7 out of the 8 patients with detectable HIV DNA at enrollment, the HIV DNA level decrea sed over time, Seven out of 15 patients at 1 year (46.7%) showed both undet ectable levels of HIV RNA in plasma and HIV DNA in lymphocytes (p<0.05); th ese patients had a higher CD4+T cell count at baseline (mean 75 versus 25 / mm(3)) and a higher increase (306 versus 177 / mm3) after 1 year, PCR-base d dilution assay carried out at 1 year showed that all patients had a consi stent amount of HIV DNA positive- CD4+T lymphocytes and macrophages, with h igher values in these last cells. The data indicate that a durable reservoir of virus is still present in bot h lymphocytes and monocytes, even after long-lasting HAART treatment.