The effect of acute infections on HIV-1 viral load and the expression of immune activation markers among HIV-infected adults

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Introduction: HTV replication may be induced by immune activation due to acute infections and vaccinations. Objectives: We studied the effect of common acute infections (e.g. PCP, bacterial pneumonia, bacteremia and cellulitis) on HIV replication and the expression of markers of immune activation. Methods: We prospectively evaluated 32 HTV-infected adults (18 females and 14 males, median CD4 count 91 cells/ml) on stable or no antiretroviral therapy with documented acute infections. HIV RNA levels (RT-PCR) and serum markers of immune activation including TNF-α, soluble (s)TNF-R1, STNF-R2, IL-6, IL-10, IL-2, sIL-2R, sCD4, and sCD8 were assessed in available plasma at four time points: preillness, acute illness (within 48 hours), two week and four week convalescent visits. Results: HIV RNA levels (median copies/ml) were as follows: Visit Type (n) Day HIV RNA Comparison Δ for Paired Samples Pre-illness (19) -60 122,399 NA NA Acute (32) 0 429,393 Pre + 458,102 (p=0.001) Two-week (20) 15 267,759 Acute - 103,862 (p=0.01) Four-week (14) 30 177,123 Acute - 196,024 (p-0.025) Cross-sectional linear regression analysis revealed a significant correlation between viral load and SIL-2R. The increase in HIV RNA with illness was correlated with increases in TNF-R2, SIL-2R, and IL-10, while the decrease at 4 weeks was correlated with decreases in TNF-R2 and SIL-2R. TNF-α, IL-2, IL-6, sCD8, and sCD4 were not correlated with HTV RNA levels or changes. Conclusions: Some common acute infections are associated with transient increases in plasma HIV RNA levels (duration 2-4 weeks). Significant changes in viral load during acute illness may be the result of immune activation. Viral load measurements should be interpreted cautiously during periods of possible immune activation.

Original languageEnglish (US)
Pages (from-to)358
Number of pages1
JournalClinical Infectious Diseases
Issue number2
Publication statusPublished - 1997


ASJC Scopus subject areas

  • Immunology

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