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M94A3039.TXT
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1994-10-25
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Document 3039
DOCN M94A3039
TI Comparison of HIV viral load markers during therapy.
DT 9412
AU Donovan R; Bush C; Manzor O; Golembiesky A; Baxa D; Markowitz N;
Saravolatz L; Henry Ford Hospital, Detroit, MI 48202.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):168 (abstract no. PB0099). Unique
Identifier : AIDSLINE ICA10/94369536
AB OBJECTIVE: This study compared the changes in viral load measured by two
plasma markers (HIV RNA and HIV p24 antigen) and one cellular marker
(HIV unintegrated DNA, uDNA) during nucleoside therapy. METHODS:
Peripheral blood was obtained from 19 HIV-infected patients (median CD4
count = 153/microliters) just prior to starting therapy, and at 8 weeks
and 1 year. Plasma was used to determine: 1) immune complex dissociated
HIV p24 antigen (Coulter), and 2) HIV RNA using the Branch Chain DNA
assay (Chiron). Peripheral blood mononuclear cells were isolated, and
the DNA extracted into high and low molecular weight fractions using a
modified Hirt procedure. The HIV copy number in both fractions was
determined using a quantitative PCR assay, and the percentage of HIV
uDNA was calculated. RESULTS: HIV plasma RNA was detected in 13 of 19
patients (mean +/- 95% C.L. = 125,000 +/- 68,000 copies) prior to
therapy. At 8 weeks post therapy, the mean HIV plasma RNA copy number
fell to 53,000 (p = .008). The drop occurred in 12 of 13 patients
positive for HIV RNA and the average drop was 52%. At one year, however,
the mean HIV plasma RNA copy number increased to 98,000, and 5 of the 13
patients had levels of HIV RNA above their baseline level. Plasma HIV
p24 antigen was detected in 15 of 19 patients (mean +/- 95% C.L. = 72
+/- 36 pg/ml) prior to therapy. At 8 weeks post therapy, the mean HIV
plasma p24 antigen level fell to 49 +/- 21 pg/ml (p = .14). The drop
occurred in 11 of 15 patients positive for HIV p24 and the average drop
was 27%. At one year the HIV plasma p24 antigen level number was above
baseline in 8 of the 15 patients. There was little correlation between
p24 antigen level and the HIV RNA copy number in plasma at any time
point. HIV uDNA was detected in 12 of 14 patients (mean +/- 95% C.L. =
35% +/- 15%) prior to therapy. At 8 weeks post therapy, the mean percent
HIV uDNA fell to 5% (p = .0004). The drop occurred in all patients
positive for HIV uDNA. At one year the HIV uDNA level remained below
baseline in all but two patients. DISCUSSION AND CONCLUSIONS: Care
should be taken in interpreting different markers of HIV viral load in
clinical trials and for monitoring therapeutic efficacy in patients
since they have different sensitivities and may respond differently
during therapy.
DE Antiviral Agents/*THERAPEUTIC USE DNA, Viral/*BLOOD Female Follow-Up
Studies Human HIV/DRUG EFFECTS/*GENETICS HIV Core Protein p24/*BLOOD
HIV Infections/BLOOD/*DIAGNOSIS/DRUG THERAPY Leukocyte Count/DRUG
EFFECTS Male RNA, Viral/*BLOOD T4 Lymphocytes/IMMUNOLOGY Virus
Replication/DRUG EFFECTS MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).