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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
HIV Infection is Active and Progressive in Lymphoid Tissue

April 5, 1993
Nature (03/25/93) Vol. 362, No. 6418, P. 355 (Pantaleo,

HIV disease is active and progressive even when there is little evidence of disease activity and by readily measured viral parameters in the peripheral blood, and the patient is experiencing asymptomatic HIV infection, write Giuseppe Pantaleo et al. of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Md. Primary infection with HIV is typically followed by a burst of viremia with or without clinical symptoms. This is usually followed by a prolonged period of clinical latency. During the latency period there is little, if any, detectable viremia, the numbers of infected cells in the blood are very low, and it is extremely difficult to demonstrate virus expression in these cells. The researchers evaluated viral burden and levels of virus replication simultaneously in the blood and lymphoid organs of the same individuals at various stages of HIV disease. They found that during clinical latency, HIV accumulates in the lymphoid organs and replicates actively despite a low viral burden and low-to-absent viral replication in peripheral blood mononuclear cells (PBMC). Hence, a state of true microbiological latency does not exist during the course of HIV infection. The peripheral blood does not accurately reflect the actual state of HIV disease, particularly early in the clinical course of HIV infection, conclude the authors.