Correlation between plasma HIV-1 RNA levels and the rate of immunologic decline

To determine the influence of HIV-1 replication on immunologic decline and clinical outcome, we quantified the HIV-1 plasma viral load in 20 patients at different times over a mean period of 10.8 months. Quantitation was performed by branched DNA signal amplification (bDNA) and p24 antigenemia. immunologic status was assessed through beta(2)-microglobulin and CD4(+) cell count determinations. CD4(+) cell decline was expressed as a slope of the regression line constructed by the logarithms of CD4(+) cell count observations. Mean values of plasma viral load were correlated with CD4(+) cell decline and mean beta(2)-microglobulin levels. Significant correlation was observed between plasma viral load quantified by the bDNA technique and CD4(+) cell decline. No significant correlation was observed between plasma viral load quantified by p24 antigenemia and CD3(+) cell decline. A significant correlation was observed between plasma viral load and beta(2)-microglobulin levels. Immunologic decline was better predicted from HIV-1 RNA levels than from the CD4(+) cell count. Significantly higher plasma viral load was observed in patients who had clinical progression of HIV-1 infection. Thus, HIV-1 plasma viral load quantified by a highly reliable technique such as bDNA showed that the immunologic decline is closely related to HIV-1 RNA replication.