Human immunodeficiency virus type 1-infected persons with residual diseaseand virus reservoirs on suppressive highly active antiretroviral therapy can be stratified into relevant virologic and immunologic subgroups

A significant percentage of human immunodeficiency virus type 1 (HIV-1)-inf ected persons treated with highly active antiretroviral therapy (HAART) wil l develop plasma HIV-1-specific virion RNA levels <50 copies/mL. HIV-1-infe cted persons receiving virally suppressive HAART were studied with a viral outgrowth assay of the patients' peripheral blood mononuclear cells (PBMC), and a quantitative polymerase chain reaction assay was used to analyze HIV -1 2-long terminal repeat (2-LTR) circular DNA in PBMC, which indicates new HIV-1 infections of cells in vivo. Viral outgrowth in vitro correlated inv ersely with the level of peripheral blood CD4(+) T lymphocytes. Detection a nd quantitation of 2-LTR circular DNA correlated strongly with viral outgro wth patterns and inversely with CD4(+) T lymphocyte counts. Relevant subgro ups of HIV-1-infected subjects on suppressive HAART with residual viral dis ease and reservoirs can now be stratified.