Evolutionary pattern of human immunodeficiency virus (HIV) replication and distribution in lymph nodes following primary infection: Implications for antiviral therapy

Giuseppe Pantaleo, Oren J. Cohen, Timothy Schacker, Mauro Vaccarezza, Cecilia Graziosi, G. Paolo Rizzardi, James Kahn, Cecil H. Fox, Steven M. Schnittman, David H. Schwartz, Lawrence Corey, Anthony S. Fauci

Research output: Contribution to journalArticlepeer-review

118 Scopus citations

Abstract

Evolutionary patterns of virus replication and distribution in lymphoid tissue during the early phases of HIV infection have not been delineated. Lymph node (LN) biopsies were excised from patients at different times after the estimated time of primary infection. Within 3 months of the acute vital syndrome, HIV was mostly present in individual virus-expressing cells in LNs; trapping of virions in the follicular dendritic cell (FDC) network was minimal or absent, but was the predominant form of HIV detected in LNs of subjects with chronic infection, either recent (4-20 months after primary infection) or long-term (>2-3 years after primary infection). Plasma viremia was significantly higher in patients during the first 3 months than in those recently infected; however, there were no significant differences in the number of virus-expressing cells per square millimeter of LN tissue in these two groups. Numbers of virus-expressing cells in lymphoid tissue were significantly lower in the subjects with long-term infection than in the other two groups. Therefore, during the transition from primary to chronic HIV infection, the level of HIV replication in lymphoid tissue remains elevated despite the fact that viremia is significantly downregulated. These findings have implications for therapeutic strategies in primary HIV infection and in recent seroconvertors.

Original languageEnglish (US)
Pages (from-to)341-345
Number of pages5
JournalNature Medicine
Volume4
Issue number3
DOIs
StatePublished - Apr 14 1998

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