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

• Published in: Journal of medical virology Vol. 56; no. 3; pp. 259 - 263
• Main Authors: Kupfer, Bernd, Kaiser, Rolf, Rockstroh, Jürgen Kurt, Matz, Bertfried, Schneweis, Karl Eduard
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.11.1998; Wiley-Liss
• Subjects: AIDS/HIV; Biological and medical sciences; CD4 Lymphocyte Count; CD4+ T-cell count; Cells, Cultured; Coculture Techniques; Cohort Studies; Cytopathogenic Effect, Viral; Disease Progression; HIV Infections - immunology; HIV Infections - mortality; HIV Infections - virology; HIV-1 - isolation & purification; HIV-1 - pathogenicity; HIV-1 - physiology; Human viral diseases; Humans; Infectious diseases; Leukocytes, Mononuclear - virology; Longitudinal Studies; Medical sciences; PBMC coculture; Phenotype; Prognosis; Retrospective Studies; RNA, Viral - blood; Survival Rate; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virus Cultivation; Human; Immunopathology; HIV-1 virus; Pathogenesis; Evolutivity; Retroviridae; AIDS; Immune deficiency; Lentivirus; Cell subpopulation; Infection; Virus; Phenotype; Viral disease; T-Lymphocyte; Human immunodeficiency virus; Predictive factor; Viral load; Quantitative analysis
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/(SICI)1096-9071(199811)56:3<259::AID-JMV14>3.0.CO;2-9

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. J. Med. Virol. 56:259–263, 1998. © 1998 Wiley‐Liss, Inc.