High concentration of peripheral blood mononuclear cells harboring infectious virus correlates with rapid progression of human immunodeficiency virus type 1-related diseases.

In a cohort of 103 asymptomatic seropositive subjects (Centers for Disease Control and Prevention [CDC] stage II/III) followed for 2 years, the concentration of peripheral blood mononuclear cells harboring infectious human immunodeficiency virus (HIV) type 1 (viral burden) was correlated with the rate of decrease of CD4 cell count (RD-CD4; R = .857). Rapidly progressing patients (RD-CD4 > or = 60%; n = 18) had a high viral burden (mean +/- SE, 572 +/- 202 cells/mL) and an 89% progression to CDC IV-A-C, while stable patients (RD-CD4 < 30%; n = 55) had a low viral burden (mean +/- SE, 28 +/- 4 cells/mL) and remained asymptomatic. Slowly progressing patients (RD-CD4 > or = 30 and < 60%; n = 30) showed an intermediate viral burden (mean +/- SE, 131 +/- 9 cells/mL) and a 10% CDC IV-A-C progression. Quantitative determination of infectious virus in blood cells adds important information on the prognosis of HIV-1 infection.