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).