Effect of highly active antiretroviral therapy on viral burden in the lungs of HIV-infected subjects.

TitleEffect of highly active antiretroviral therapy on viral burden in the lungs of HIV-infected subjects.
Publication TypeJournal Article
Year of Publication2008
AuthorsIii HLTwigg, Weiden M, Valentine F, Schnizlein-Bick CT, Bassett R, Zheng L, Wheat J, Day RB, Rominger H, Collman RG, Fox L, Brizz B, Dragavon J, Coombs RW, R Bucy P
Corporate AuthorsAIDS Clinical Trials Group Protocol 723 Team
JournalJ Infect Dis
Volume197
Issue1
Pagination109-16
Date Published2008 Jan 1
ISSN0022-1899
KeywordsAdult, Antiretroviral Therapy, Highly Active, Bronchoalveolar Lavage Fluid, DNA, Viral, Female, HIV Infections, HIV-1, Humans, Longitudinal Studies, Lung, Male, Pulmonary Alveoli, RNA, Viral, Viral Load
Abstract

BACKGROUND: Human immunodeficiency virus (HIV) is readily detectable in the lungs of infected subjects and leads to an accumulation of CD8(+) lymphocytes in the alveolar space. Although highly active antiretroviral therapy (HAART) is effective in reducing viremia, less is known about its effect on tissue compartments. The AIDS Clinical Trials Group Protocol 723 Team evaluated the effect of HAART on lung viral load and cellular constituents.

METHODS: Bronchoalveolar lavage (BAL) fluid and blood were collected before initiation of HAART and again at 4 and 24 weeks after initiation of therapy. The BAL cell differential was determined, lymphocyte phenotyping was performed, and acellular BAL fluid, plasma HIV RNA load, and BAL cell and peripheral blood mononuclear cell HIV RNA and DNA loads were measured.

RESULTS: HAART induced a rapid decrease in HIV that was detectable in acellular BAL fluid and a slower decrease in the HIV RNA and DNA loads in BAL cells. HAART was associated with a significant decrease in the absolute number and percentage of CD8(+) alveolar lymphocytes. There was a significant correlation between residual BAL cell DNA at 24 weeks and the absolute number of CD4(+) lymphocytes in the alveolar space.

CONCLUSION: HAART is associated with a significant decrease in the pulmonary HIV burden and a return of alveolar cellular constituents to normal.

DOI10.1086/523766
Alternate JournalJ. Infect. Dis.
PubMed ID18171293
Grant ListAI 25859 / AI / NIAID NIH HHS / United States
AI 27664 / AI / NIAID NIH HHS / United States
AI 27665 / AI / NIAID NIH HHS / United States
AI 32775 / AI / NIAID NIH HHS / United States
AI 34832 / AI / NIAID NIH HHS / United States
AI 38855 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
HL057879 / HL / NHLBI NIH HHS / United States
MO1 RR00096 / RR / NCRR NIH HHS / United States
MO1 RR750 / RR / NCRR NIH HHS / United States
P20 RR11126 / RR / NCRR NIH HHS / United States
R01 HL59834 / HL / NHLBI NIH HHS / United States