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Research Article| Volume 14, ISSUE 2, P301-311, June 1994

HIV-1 Burden as a Marker of Disease Progression and Clinical Response to Therapy in AIDS

  • Robert W. Coombs
    Correspondence
    Address reprint requests to Robert W. Coombs, MD, PhD, Virology Office, Room 9301, Pacific Medical Center, 1200 12th Avenue South, Seattle, WA 98144.
    Affiliations
    From the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington
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      This article reviews the pathogenetic significance of changes in virus infection of HIV-1. Virus burden and disease progression are discussed, as well as responses to therapy and implications for clinical trial design and clinical management.
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      References

        • Achim C.L.
        • Heyes M.P.
        • Wiley C.A.
        Quantitation of human immunodeficiency virus, immune activation factors, and quinolinic acid in AIDS brains.
        J Clin Invest. 1993; 91: 2769
        • Albert J.
        • Gaines H.
        • Sönnerborg A.
        • et al.
        Isolation of human immunodeficiency virus (HIV) from plasma during primary HIV infection.
        J Med Virol. 1987; 23: 67
        • Anderson D.J.
        • Obrien T.R.
        • Politch J.A.
        • et al.
        Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type-1 in semen.
        JAMA. 1992; 267: 2769
        • Clark S.J.
        • Saag M.S.
        • Decker W.D.
        • et al.
        High titers of cytopathic virus in plasma of patients with symptomatic primary HIV-1 infection.
        N Engl J Med. 1991; 324: 954
        • Collier A.C.
        • Bozzette S.
        • Coombs R.W.
        • et al.
        A pilot study of low-dose zidovudine in human immunodeficiency virus infection.
        N Engl J Med. 1990; 323: 1015
        • Collier A.C.
        • Coombs R.W.
        • Fischl M.A.
        • et al.
        Combination therapy with zidovudine and didanosine compared with zidovudine alone in HIV-1 infection.
        Ann Intern Med. 1993; 119: 786
        • Collier A.C.
        • Marra C.
        • Coombs R.W.
        • et al.
        Central nervous system manifestations in human immunodeficiency virus infection without AIDS.
        J Acquir Immune Defic Syndr. 1992; 5: 229
        • Coombs R.W.
        • Collier A.C.
        • Allain J.P.
        • et al.
        Plasma viremia in human immunodeficiency virus infection.
        N Engl J Med. 1989; 321: 1626
        • Coombs R.W.
        • Collier A.C.
        • Corey L.
        Plasma viremia as an endpoint in evaluating the effectiveness of drugs against human immunodeficiency virus type-1 (HIV) infection: Natural history of plasma viremia and monitoring of antiretroviral therapy.
        in: Andrieu J.M. Cramer P. Workshop on viral quantitation in HIV infection. John Libbey Eurotext, Paris1991: 9
      1. Coombs RW, Gjerset G, Corey L: Plasma HIV viremia as a predictor of progression to AIDS in HIV-infected hemophiliacs [abstract 118]. In 30th Interscience Conference on Antimicrobial Agents and Chemotherapy, Atlanta, Georgia, 1990, p 106

        • Coombs R.W.
        • Krieger J.N.
        • Collier A.C.
        • et al.
        Plasma virmeia and recovery of HIV from semen: Implications for transmission and therapy.
        in: Mélica F. First International Symposium on AIDS and Reproduction. 1990. Basel, Karger, Genoa1992: 145
        • Corey L.
        • Coombs R.W.
        The natural history of HIV infection: Implications for the assessment of antiretroviral therapy.
        Clin Infect Dis. 1993; 16: S2
      2. D’Aquila R, Johnson V, Kuritzkes D, et al: HIV-1 drug resistance and syncytium-inducing phenotype: Associations with disease progression among ACTG 116B/117 subjects [abstract PO-B26-2046]. In IXth International Conference on AIDS, Berlin, 1993, p 476

        • Daar E.S.
        • Moudgil T.
        • Meyer R.D.
        • et al.
        Transient high levels of viremia in patients with primary human immunodeficiency virus type-1 infection.
        N Engl J Med. 1991; 324: 961
        • DeGruttola V.
        • Beckett L.A.
        • Coombs R.W.
        • et al.
        Serum p24 antigen level as an intermediate end point in clinical trials of zidovudine in people infected with human immunodeficiency virus type 1.
        J Infect Dis. 1994; 169: 713
        • Ehrnst A.
        • Sonnerborg A.
        • Bergdahl S.
        • et al.
        Efficient isolation of HIV from plasma during different stages of HIV infection.
        J Med Virol. 1988; 26: 23
        • Embretson J.
        • Zupancic M.
        • Ribas J.L.
        • et al.
        Massive covert infection of helper T-lymphocytes and macrophages by HIV during the incubation period of AIDS.
        Nature. 1993; 362: 359
        • Fahey J.L.
        • Taylor J.M.
        • Detels R.
        • et al.
        The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1.
        N Engl J Med. 1990; 322: 166
        • Falk L.J.
        • Paul D.
        • Landay A.
        • et al.
        HIV isolation from plasma of HIV-infected persons.
        N Engl J Med. 1987; 316: 1547
        • Fauci A.S.
        The human immunodeficiency virus: Infectivity and mechanisms of pathogenesis.
        Science. 1988; 239: 617
        • Fauci A.S.
        Multifactorial nature of human immunodeficiency virus disease: Implications for therapy.
        Science. 1993; 262: 1011
        • Fenyo E.M.
        • Morfeldt-Manson L.
        • Chiodi F.
        • et al.
        Distinct replicative and cytopathic characteristics of human immunodeficiency virus isolates.
        J Virol. 1988; 62: 4414
        • Hammer S.
        • Crumpacker C.
        • D’Aquila R.
        • et al.
        Use of virologic assays for detection of human immunodeficiency virus in clinical trials: Recommendations of the AIDS Clinical Trials Group Virology Committee.
        J Clin Microbiol. 1993; 31: 2557
        • Ho D.D.
        • Moudgil T.
        • Alam M.
        Quantitation of human immunodeficiency virus type 1 in the blood of infected persons.
        N Engl J Med. 1989; 321: 1621
        • Hollinger F.B.
        ACTG virology manual for HIV laboratories. ed 2. Division of AIDS, National Institutes of Allergy and Infectious Diseases, NIH, Bethesda, MD1993
        • Hollinger F.B.
        • Bremer J.W.
        • Myers L.E.
        • et al.
        Standardization of sensitive human immunodeficiency virus coculture procedures and establishment of a multicenter quality assurance program for the AIDS Clinical Trials Group.
        J Clin Microbiol. 1992; 30: 1787
        • Holodniy M.
        • Katzenstein D.
        • Winters M.
        • et al.
        Measurement of HIV virus load and genotypic resistance by gene amplification in asymptomatic subjects treated with combination therapy.
        J Acquir Immune Defic Syndr. 1993; 6: 366
        • Katzenstein D.A.
        • Holodniy M.
        • Israelski D.M.
        • et al.
        Plasma viremia in human immunodeficiency virus infection: relationship to stage of disease and antiviral treatment.
        J Acquir Immune Defic Syndr. 1992; 5: 107
        • Koot M.
        • Keet I.P.M.
        • Vos A.H.V.
        • et al.
        Prognostic value of HIV-1 syncytium-inducing phenotype for rate of CD4+ cell depletion and progression to AIDS.
        Ann Intern Med. 1993; 118: 681
        • Koot M.
        • Vos A.H.V.
        • Keet R.P.M.
        • et al.
        HIV-1 biological phenotype in long-term infected individuals evaluated with an MT-2 cocultivation assay.
        AIDS. 1992; 6: 49
        • Krieger J.N.
        • Coombs R.W.
        • Collier A.C.
        • et al.
        Recovery of human immunodeficiency virus type 1 from semen: minimal impact of stage of infection and current antiviral chemotherapy.
        J Infect Dis. 1991; 163: 386
      3. Lin HJ, Myers LE, Yen-Lieberman B, et al: Multicenter evaluation of methods for the quantitation of plasma HIV-1 RNA. J Infect Dis, in press

        • Michael N.L.
        • Vahey M.
        • Burke D.S.
        • et al.
        Viral DNA and messenger RNA expression correlate with the stage of human immunodeficiency virus (HIV) type-1 infection in humans—evidence for viral replication in all stages of HIV disease.
        J Virol. 1992; 66: 310
        • Pantaleo G.
        • Graziosi C.
        • Demarest J.F.
        • et al.
        HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease.
        Nature. 1993; 362: 355
        • Phair J.
        • Jacobson L.
        • Detels R.
        • et al.
        Acquired immune deficiency syndrome occurring within 5 years of infection with human immunodeficiency virus type-l-the Multicenter AIDS Cohort Study.
        J Acquir Immune Defic Syndr. 1992; 5: 490
        • Piatak M.
        • Saag M.S.
        • Yang L.C.
        • et al.
        High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR.
        Science. 1993; 259: 1749
        • Roos M.T.L.
        • Lange J.M.A.
        • Degoede R.E.Y.
        • et al.
        Viral phenotype and immune response in primary human immunodeficiency virus type-1 infection.
        J Infect Dis. 1992; 165: 427
        • Saag M.S.
        • Crain M.J.
        • Decker W.D.
        • et al.
        High-level viremia in adults and children infected with human immunodeficiency virus-relation to disease stage and CD4+ lymphocyte levels.
        J Infect Dis. 1991; 164: 72
        • Sande M.A.
        • Carpetner C.J.
        • Cobbs C.G.
        • et al.
        Antiretroviral therapy for adult HIV-infected patients: Recommendations from a state-of-the-art conference.
        J Am Med Assoc. 1993; 270: 2583
        • Schnittman S.M.
        • Greenhouse J.J.
        • Psallidopoulos M.C.
        • et al.
        Increasing viral burden in CD4+ T cells from patients with human immunodeficiency virus (HIV) infection reflects rapidly progressive immunosuppression and clinical disease.
        Ann Intern Med. 1990; 113: 438
        • Schuitemaker H.
        • Koot M.
        • Kootstra N.A.
        • et al.
        Biological phenotype of human immunodeficiency virus type-1 clones at different stages of infection: Progression of disease is associated with a shift from monocytotropic to T-cell-tropic virus populations.
        J Virol. 1992; 66: 1354
        • Schuitemaker H.
        • Kootstra N.A.
        • Degoede R.
        • et al.
        Monocytotropic Human Immunodeficiency virus type-1 (HIV-1) variants detectable in all stages of HIV-1 infection lack T-cell line tropism and syncytium-inducing ability in primary T-cell culture.
        J Virol. 1991; 65: 356
        • Spector S.A.
        • Hsia K.
        • Pratt D.
        • et al.
        Virologie markers of human immunodeficiency virus type-1 in cerebrospinal fluid.
        J Infect Dis. 1993; 168: 68
        • Tartaglione T.A.
        • Collier A.C.
        • Coombs R.W.
        • et al.
        Acquired immunodeficiency syndrome: Cerebrospinal fluid findings in patients before and during long-term oral zidovudine therapy.
        Arch Neurol. 1991; 48: 695
        • Tersmette M.
        • Gruters R.A.
        • de Wolf F.
        • et al.
        Evidence for a role of virulent human immunodeficiency virus (HIV) variants in the pathogenesis of acquired immunodeficiency syndrome: Studies on sequential HIV isolates.
        J Virol. 1989; 63: 2118
      4. Veenstra J, Koot M, Boucher EC, et al: The role of HIV-1 biological phenotype in the effect of AZT on immunological markers in HIV-1 infected subjects without AIDS diagnosis [abstract PO-B26-2015]. In IXth International Conference on AIDS, Berlin, 1993, p 471

        • Zagury D.
        • Fourchard M.
        • Vol J.C.
        • et al.
        Detection of infectious HTLV-III/LAV virus in cell-free plasma from AIDS patients.
        Lancet. 1985; 2: 505