Document 0043
 DOCN  M95A0043
 TI    Decreased human immunodeficiency virus type 1 plasma viremia during
       antiretroviral therapy reflects downregulation of viral replication in
       lymphoid tissue.
 DT    9510
 AU    Cohen OJ; Pantaleo G; Holodniy M; Schnittman S; Niu M; Graziosi C;
       Pavlakis GN; Lalezari J; Bartlett JA; Steigbigel RT; et al; Laboratory
       of Immunoregulation, National Institute of Allergy and; Infectious
       Diseases, Bethesda, MD 20892, USA.
 SO    Proc Natl Acad Sci U S A. 1995 Jun 20;92(13):6017-21. Unique Identifier
       : AIDSLINE MED/95320206
 AB    Although several immunologic and virologic markers measured in
       peripheral blood are useful for predicting accelerated progression of
       human immunodeficiency virus (HIV) disease, their validity for
       evaluating the response to antiretroviral therapy and their ability to
       accurately reflect changes in lymphoid organs remain unclear. In the
       present study, changes in certain virologic markers have been analyzed
       in peripheral blood and lymphoid tissue during antiretroviral therapy.
       Sixteen HIV-infected individuals who were receiving antiretroviral
       therapy with zidovudine for > or = 6 months were randomly assigned
       either to continue on zidovudine alone or to add didanosine for 8 weeks.
       Lymph node biopsies were performed at baseline and after 8 weeks. Viral
       burden (i.e., HIV DNA copies per 10(6) mononuclear cells) and virus
       replication in mononuclear cells isolated from peripheral blood and
       lymph node and plasma viremia were determined by semiquantitative
       polymerase chain reaction assays. Virologic and immunologic markers
       remained unchanged in peripheral blood and lymph node of patients who
       continued on zidovudine alone. In contrast, a decrease in virus
       replication in lymph nodes was observed in four of six patients who
       added didanosine to their regimen, and this was associated with a
       decrease in plasma viremia. These results indicate that decreases in
       plasma viremia detected during antiretroviral therapy reflect
       downregulation of virus replication in lymphoid tissue.
 DE    Adult  Comparative Study  Didanosine/*THERAPEUTIC USE  DNA,
       Viral/ANALYSIS  Female  Human  HIV Infections/BLOOD/*DRUG
       THERAPY/VIROLOGY  HIV-1/*ISOLATION & PURIF  Lymph Nodes/VIROLOGY
       Lymphocytes/VIROLOGY  Male  Support, U.S. Gov't, P.H.S.  Time Factors
       Viremia/BLOOD/*DRUG THERAPY/VIROLOGY  Zidovudine/*THERAPEUTIC USE
       CLINICAL TRIAL  JOURNAL ARTICLE  MULTICENTER STUDY  RANDOMIZED
       CONTROLLED TRIAL

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