Prognostic value of kinetic parameters of HIV isolation from peripheral blood mononuclear cells

To assess the correlations between clinical and biological stages of HIV infection and HIV isolation, peripheral blood mononuclear cells from 389 HIV-infected patients were studied by 30-day cocultures with normal lymphocytes. HIV isolation was successful in 279/389 patients (71.7%). Positive isolation was more frequent in CDC IV cases (82%) than in CDC II and III cases (63.6% and 78.4% respectively). There was a close correlation between culture positivity and serum beta 2-microglobulin, CD4+ cell counts and serum p24 antigen. The day of peak detection of reverse transcriptase activity or peak p24 antigen in coculture supernatants was selected as a coculture kinetic parameter. The day of peak detection of HIV in culture occurred earlier in CDC IV cases than in CDC II and III cases, and was a prognostic factor in AIDS progression at 2 years. These data suggest that in vitro parameters related to both viral burden and replicative capacity of HIV isolates are relevant indicators of disease progression.