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Opportunistic events and p17 expression in the bone marrow of human immunodeficiency virus-infected patients
1Department of Pathology, University of Texas, Southwestern Medical Center at Dallas.
Abstract:
Bone marrow biopsies from 114 human immunodeficiency virus (HIV)-infected patients were stained with an anti-p17 monoclonal antibody to detect active HIV replication and associated factors. Immunoreactive p17 was found as virus-like particles in macrophages and dendritic cells and occasionally in megakaryocytes in 62 of 114 marrows and was considered evidence of active HIV replication. Immunoreactive p17 was not found significantly more often in the marrows of patients with lower CD4 cell counts; however, it was found significantly more in the marrows of patients with concurrent mycobacterial or fungal infections or lymphoma (chi 2 = 12.1, P < .001). Immunoreactive p17 was even more frequent when these opportunistic diseases were found in the biopsied marrow (chi 2 = 20.5, P < .001). The association of active HIV replication with certain opportunistic diseases, but not with lower CD4 cell counts, raises the possibility that these opportunistic diseases may under some circumstances be a cause as well as a consequence of active HIV replication.
Insights
Active human immunodeficiency virus (HIV) replication in bone marrow was detected using p17 antibody. This active replication correlated with opportunistic infections and lymphoma, not CD4 counts, suggesting a complex relationship.
Area of Science:
- Virology
- Immunology
- Hematology
Background:
- Bone marrow is a critical site for human immunodeficiency virus (HIV) replication.
- Understanding the dynamics of HIV replication in bone marrow is essential for managing disease progression.
Purpose of the Study:
- To investigate the presence and significance of active HIV replication in bone marrow biopsies.
- To explore the association between active HIV replication and opportunistic infections or specific cancers in HIV-infected patients.
Main Methods:
- Bone marrow biopsies from 114 HIV-infected patients were analyzed.
- Immunohistochemistry using an anti-p17 monoclonal antibody was employed to detect active HIV replication.
- Statistical analysis was performed to correlate p17 detection with CD4 cell counts and opportunistic diseases.
Main Results:
- Active HIV replication, indicated by p17 detection, was found in 62 of 114 patients.
- Active HIV replication was significantly more frequent in patients with concurrent mycobacterial, fungal infections, or lymphoma.
- No significant association was found between active HIV replication and lower CD4 cell counts.
Conclusions:
- Active HIV replication occurs in the bone marrow of a significant proportion of HIV-infected patients.
- Opportunistic diseases like mycobacterial/fungal infections and lymphoma are strongly associated with active HIV replication in bone marrow.
- The findings suggest that opportunistic diseases may contribute to, as well as result from, active HIV replication in bone marrow.