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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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HIV in body fluids during primary HIV infection: implications for pathogenesis, treatment and public health [Pilcher CD et al. AIDS 2001;15: 837]: The authors from North Carolina investigated 17 patients with acute HIV infection to determine HIV RNA levels in blood, CSF, seminal, cervicovaginal lavage and saliva at 8-70 days from onset of symptoms. The results showed the highest levels in blood, saliva and genital tract at the time of symptoms. Viral replication was suppressed at all sites with HAART. The authors conclude that there is wide spread dissemination of the virus by the time symptoms are recognized and that treatment is unlikely to limit this dissemination to selected tissue compartments.
Comment: The observations in this study have been previously predicted on the basis of multiple studies in patients and animal models. Nevertheless, this emphasizes some important points. One of the more important is that recognition of primary HIV infection with treatment may be indicated not only for ultimate outcome, but also for reduction in HIV transmission.
posted 5/22/2001





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