Quantitative Analysis of Viral Burden in Tissues from Adults and Children with Symptomatic Human Immunodeficiency Virus Type 1 Infection Assessed by Polymerase Chain Reaction

Abstract

The amount of human immunodeficiency virus type 1 (HIV-1) in various tissues was investigated by polymerase chain reaction (PCR) in 16 patients with end-stage HIV-1 infection and 7 patients with symptomatic but less advanced disease. During postmortem study of the 16 endstage patients, HIV-l DNA was found most often in lymph nodes and the spleen (both 100%), lung (93.8%), and colon (87.5%). Biopsied lymph nodes from the 7 symptomatic patients contained substantially higher copy numbers of HIV-1 RNA and DNA than did peripheral blood mononuclear cells (PBMC). Plasma viral RNA levelscorrelated significantlywith the amount of HIV-l RNA in PBMC (r² = .86, P = .0025) butnotwiththelevelofviralRNAinlymphnodesin patients with symptomatic HIV-1 infection.Thesedatasuggestthat althoughlymphnodesrepresent the main site for HIV-1 infection and replication, the level of circulating viral burden may not be solely determined by the magnitude of active HIV-1 replication in lymph nodes.