Role of HIV-1 phenotype in viral pathogenesis and its relation to viral load and CD4+ T-cell count

✍ Scribed by Kupfer, Bernd; Kaiser, Rolf; Rockstroh, Jürgen Kurt; Matz, Bertfried; Schneweis, Karl Eduard

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 95 KB
• Volume: 56
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/(sici)1096-9071(199811)56:3<259::aid-jmv14>3.0.co;2-9

✦ Synopsis

The predictive value of HIV-1 phenotype in peripheral blood mononuclear cell (PBMC) coculture and the relation among viral phenotype, viral load, and CD4+ T-cell count were examined in two studies. In study A, 132 HIV-1-infected individuals were examined retrospectively for the relation between the result of their initial HIV cultivation in PBMC coculture and survival rate 6 years later. In study B, 176 patients were examined since 1994 for markers of HIV disease progression. HIV-1 phenotype was determined by PBMC cocultivation, viral load by NASBA HIV RNA QT System, and CD4+ T-cell count by flow cytometry. In study A, the percentage of survival for patients with initial negative virus culture was significantly higher (95%) than in patients with nonsyncytia-inducing (NSI) isolates (78%) and syncytia-inducing (SI) isolates (21%) (P < 0.05 and P < 0.0001, respectively). When SI phenotype was subdivided into moderately cytopathogenic and highly cytopathogenic, significant differences in the rate of survival between these subgroups could be observed (45% vs. 14%; P < 0.05). In study B, progression from negative virus culture to the isolation of NSI variants was associated with increasing viral load (P < 0.0001) but did not affect CD4+ T-cell count significantly (P > 0.07), whereas the switch from NSI to SI virus was accompanied by significant decline of CD4+ T-cells (P < 0.0001) but no change in viral load (P > 0.21). Thus, isolation and phenotyping of HIV represents an additional striking predictive marker for progression of HIV infection.