QUANTITATION OF HUMAN IMMUNODEFICIENCY VIRUS TYPE-1 IN THE BLOOD OF INFECTED PERSONS
QUANTITATION OF HUMAN IMMUNODEFICIENCY VIRUS TYPE-1 IN THE BLOOD OF INFECTED PERSONS
复制标题
DOI：
10.1056/nejm198912143212401
复制
发表时间：
1989-12-14
影响因子：
158.5
通讯作者：
ALAM, M
中科院分区：
文献类型：
--
作者：
HO, DD;MOUDGIL, T;ALAM, M
我们采用终点稀释培养法检测了54例未接受抗病毒化疗的感染患者外周血单个核细胞（PBMC）和血浆中的感染性人类免疫缺陷病毒1型（HIV-1）水平。无症状感染、获得性免疫缺陷综合征（AIDS）和AIDS相关综合征患者血浆中的平均滴度分别为30、3500和3200组织培养感染剂量（TCID）/ml。在PBMC中，有症状患者的平均滴度（AIDS，2200，AIDS相关复合物，2700 TCID/106 PBMC）显著高于无症状患者（20 TCID/106 PBMC）。7例AIDS患者经齐多夫定治疗4周后，血浆中HIV-1滴度明显下降，但PBMC中HIV-1滴度无明显变化。此外，平均滴度在血浆中的20例患者接受长期齐多夫定治疗（130 TCID每毫升）是25倍，低于平均值为可比的未经治疗的艾滋病患者或艾滋病相关complex.We的结论，血浆和PBMC中的HIV-1水平远远高于以前的估计。这种高度的HIV-1病毒血症提出了一种可能性，即这种逆转录病毒的直接细胞病变效应可能足以解释艾滋病的发病机制。（N Engl J Med 1989;321：1621-5.）
We used end-point-dilution cultures to measure the level of infectious human immunodeficiency virus type 1 (HIV-1) in peripheral-blood mononuclear cells (PBMC) and plasma of 54 infected patients who were not receiving antiviral chemotherapy.HIV-1 was recovered from the plasma and PBMC of every seropositive patient, but from none of 22 seronegative control subjects. The mean titers in plasma were 30, 3500, and 3200 tissue-culture–infective doses (TCID) per milliliter for patients with asymptomatic infection, the acquired immunodeficiency syndrome (AIDS), and the AIDS-related complex, respectively. In PBMC, the mean titers were significantly higher for symptomatic patients (AIDS, 2200, and AIDS-related complex, 2700 TCID per 106PBMC) than asymptomatic patients (20 TCID per 106PBMC). The values for the symptomatic patients were considered to indicate that at least 1 in 400 circulating mononuclear cells harbored HIV-1.The HIV-1 titers of seven patients with AIDS or AIDS-related complex treated with zidovudine for four weeks decreased significantly in plasma but not in PBMC. In addition, the mean titer in the plasma of 20 patients receiving long-term zidovudine treatment (130 TCID per milliliter) was 25-fold lower than the mean for comparable untreated patients with AIDS or AIDS-related complex.We conclude that the levels of HIV-1 in plasma and PBMC are much higher than previous estimates. This high degree of HIV-1 viremia raises the possibility that the direct cytopathic effect of this retrovirus alone may be sufficient to explain much of the pathogenesis of AIDS. (N Engl J Med 1989;321:1621–5.)