Kalle Saksela, MD, PhD; Cladd E. Stevens, MD; Pablo Rubinstein, MD; Patricia E. Taylor, PhD; David Baltimore, PhD
To establish human immunodeficiency virus type 1 (HIV-1) messenger RNA (mRNA) expression in peripheral blood mononuclear cells as a marker of risk for progression to the acquired immunodeficiency syndrome (AIDS) in a large cohort of HIV-infected persons followed for a prolonged period.
Retrospective testing of cryopreserved, coded specimens.
Research laboratories at the New York Blood Center and the Rockefeller University.
150 homosexual men infected with HIV-1 who did not have an AIDS diagnosis at the time of testing.
Multiply spliced and unspliced HIV-1 mRNAs in total peripheral blood mononuclear cell RNA were quantitated using reverse transcriptase-initiated polymerase chain reaction (PCR) and compared with other laboratory data and clinical outcome during the subsequent 8 years.
Although HIV-1 mRNA expression generally correlated with immunologic status, it was associated with future disease progression independently of CD4+ cell counts or their rate of decrease at the time of sampling. The association of HIV-1 mRNA with disease progression in persons with CD4+ cell counts higher than the median (> 624 cells/mm3) was particularly noteworthy; further variation in the CD4+ cell counts within this group was not prognostically significant.
The expression of HIV-1 mRNA in peripheral blood mononuclear cells is a strong independent marker for future HIV disease progression, even in persons with normal T-cell subsets.
Saksela K, Stevens CE, Rubinstein P, Taylor PE, Baltimore D. HIV-1 Messenger RNA in Peripheral Blood Mononuclear Cells as an Early Marker of Risk for Progression to AIDS. Ann Intern Med. ;123:641–648. doi: 10.7326/0003-4819-123-9-199511010-00001
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Published: Ann Intern Med. 1995;123(9):641-648.
HIV, Infectious Disease.
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