The influence of CD 4+t cells, hiv disease stage and zidovudine on hiv isolation in Bahia, Brazil

Brites, Carlos; Pedroso, Célia; Silva, Nanci; Johnson Jr, Warren D; Badaró, Roberto

doi:10.1590/S0037-86821996000100002

Abstracts

HIV-l isolation was attempted on 72 individuais, including persons with knoum HIV infection and five without proven HIV infection but with indeterminate Western blot patterns, as well as on low-risk HIV seronegative persons. The ahility to detect HIV- 1 frorn culture supernatant by p24 antigen capture assay was evaluated by segregating patients by absolute CD4+ cell counts, clinicai stage of disease, p24 antigenemia and zidovudine use. The likelihood of a p24 positive HIV culture was highest among patients with CD4+ T-cell counts below 200/ul and patients with advanced clinical disease. Use of zidovudine did not affect the rate ofHIV positwity in cultures.

HIV; P24; Viral isolation; Brazil; CD4+ Tlymphocytes

Tentativa de isolamento do vírus tipo 1 da imunodeficiência adquirida (VIH-1) foi realizada em 72 indivíduos sendo 51 pacientes com sorologia positiva para o VIH-1, confirmada por Western blot; 5 doadores de sangue com padrão indeterminado ao Western blot; 3 indivíduos com diagnóstico clínico de AIDS, porém com sorologia negativa, e 13 profissionais de saúde soronegativos. Os pacientes foram estratificados de acordo com a contagem de células CD4+, estágio clínico , antigenemia (p24) e uso de zidovudine. As culturas para o VIH-1 foram positivas em 45/50 (90%) tentativas. Houve uma correlação inversa entre o número de células CD4+ e a freqüência de isolamento do VIH-1. As culturas foram positivas em 84% dos indivíduos com CD4+ <200, contra 48% d positividade naqueles com contagem de célula CD4+ acima deste valor. O uso de zidovudine não interferiu na positividade das culturas. Concluímo. que a sensibilidade dos métodos de culture qualitativo e quantitativo é similar para a detecção do VIH-1. A taxa de positividade das culturas não foi afetada pelo uso prévio de zidovudine, mas foi diretamente proporcional ao grau de imunodeficiência dos pacientes.

VIH; p24; Isolamento viral; Brasil; CD4+ linfócitos T

ARTIGO

The influence of CD 4+t cells, hiv disease stage and zidovudine on hiv isolation in Bahia, Brazil

Carlos Brites; Célia Pedroso; Nanci Silva; Warren D Johnson Jr; Roberto Badaró

Laboratório de Retrovírus. Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil, and Division of International Medicine, Cornell University Medical College, New York, NY, USA

^{Address to correspondence} Address to correspondence. Dr. C. Brites. Laboratório de Retrovírus/HUPES/UFBA. R. João das Botas s/n, Canela, 40110-160 Salvador, BA, Brazil. Phone: (55 71) 235-4866, Fax (55-71) 245-7110.

SUMMARY

HIV-l isolation was attempted on 72 individuais, including persons with knoum HIV infection and five without proven HIV infection but with indeterminate Western blot patterns, as well as on low-risk HIV seronegative persons. The ahility to detect HIV- 1 frorn culture supernatant by p24 antigen capture assay was evaluated by segregating patients by absolute CD4+ cell counts, clinicai stage of disease, p24 antigenemia and zidovudine use. The likelihood of a p24 positive HIV culture was highest among patients with CD4+ T-cell counts below 200/ul and patients with advanced clinical disease. Use of zidovudine did not affect the rate ofHIV positwity in cultures.

Key-words: HIV. P24. Viral isolation. Brazil. CD4+ Tlymphocytes.

RESUMO

Tentativa de isolamento do vírus tipo 1 da imunodeficiência adquirida (VIH-1) foi realizada em 72 indivíduos sendo 51 pacientes com sorologia positiva para o VIH-1, confirmada por Western blot; 5 doadores de sangue com padrão indeterminado ao Western blot; 3 indivíduos com diagnóstico clínico de AIDS, porém com sorologia negativa, e 13 profissionais de saúde soronegativos. Os pacientes foram estratificados de acordo com a contagem de células CD4+, estágio clínico , antigenemia (p24) e uso de zidovudine. As culturas para o VIH-1 foram positivas em 45/50 (90%) tentativas. Houve uma correlação inversa entre o número de células CD4+ e a freqüência de isolamento do VIH-1. As culturas foram positivas em 84% dos indivíduos com CD4+ <200, contra 48% d positividade naqueles com contagem de célula CD4+ acima deste valor. O uso de zidovudine não interferiu na positividade das culturas. Concluímo. que a sensibilidade dos métodos de culture qualitativo e quantitativo é similar para a detecção do VIH-1. A taxa de positividade das culturas não foi afetada pelo uso prévio de zidovudine, mas foi diretamente proporcional ao grau de imunodeficiência dos pacientes.

Palavras-chaves: VIH. p24. Isolamento viral. Brasil. CD4+ linfócitos T.

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Full text available only in PDF format.

Recebido para publicação em 08/12/94.

Research supported by grants AI26506 and TW00018 from the United States Public Health Service

1. Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gurest J, Danguet C, Axler-Blin C, Brun-Vézinet F, Rozembaum W, Montagnier L. Isolation of a T-lymphotropic Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS). Science 220:868-71, 1983
2. Gallo RC, Sarin PS, Gelmann EH Robert-Guroff M, Richardson E, Kalyanaraman VS, Mann D, Sidhu GD, Stahl RE, Zolla-Paznes S, Leibowitch J, Popovic M. Isolation of Human T-Cell Leukemia Virus in Acquired Immune Deficiency Syndrome (AIDS). Science, 220:865-8 1983.
3. Gallo RC, Salahuddin SZ, Popovic M, Shearer GM, Kaplan M, Haynes BF, Palkert J, Redfield R, Oleske J, Safai B,White G, Foster P Markham PD. Frequent Detection and Isolation of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and at Risk of AIDS. Science 224:500-3, 1984.
4. Levy JA, Hoffman AD, Kramer SM, Landis JA, Schimabukuro JM, Oshiro LS. Isolation of Lymphocytopathic Retroviruses from San Francisco Patients with AIDS. Science 225:840-2, 1984,
5. Jackson JB, Coombs RW, Sannerud K, Rhame FS, Balfour HH Jr. Rapid and Sensitive Viral Culture Method for Human Immunodeficiency Virus Type 1. Journal of Clinicai Microbiology 26:1416-8, 1988.
6. Castro BA, Weiss CD.Wiviott LD, Levy JA. Optimal Conditions for Recovering Human Immunodeficiency Virus from Peripheral Blood Mononuclear Cells. Journal of Clinicai Microbiology 26:2371-6,1988.
7. Coombs RW; Collier AC; Allain JP; Nikora B; Leuther M; Gjerset GF; Corey L. Plasma viremia in Human Immunodeflciency Virus Infection. New England Journal of Medicine 321:1626-31,1989.
8. Ho DD, Moudgil T, Alam M. Quantitation of Human Immunodeficiency Virus Type 1 in the Blood of Infected Persons. New England Journal of Medicine 321:1621-1625,1989.
9. Ministério de Saúde. AIDS - Boletim Epidemiológico, ano VI, n° 08,1993.
10. Revision of the CDC Surveillance Case Definition for Acquired Immunodeflciency Syndrome. Mortality and Morbidity Weekly Report 36(suppl 1):38-158, 1987.
11. Spira TJ, Kaplan JE, Feorino PM, Warfield DT, Fishbein DB, Bozeman LH. Human Immunodeflciency Virus Viremia as a Prognostic Indicator in Homosexual Men with Lymphadenopathy Syndrome. New England Journal of Medicine 317:1093-4,1987.
12. Burke DS, Fowler AK, Redfield RR, Dilworth S, Oster CN. Isolation of HIV-1 from the Blood of Seropositive Adults: Patients Stage of Illness and Sample Inoculum Size are Major Determinants of a Positive Culture. Journal of Acquired Immune Deficiency Syndrome 3:1159-1167,1990.
13. Jackson JB, Mac Donald KL, Cadwell J, Sullivan C, Kline WE, Hanson M, Sannerud KJ, Stramer SL, Fildes NJ, Kwok SY. Absence of HIV Infection in Blood Donors with Indeterminate Western blot Test for Antibody to HIV1. New England Journal of Medicine 332:217-222,1990.
14. Celum CL, Coombs RW, Lafferty W., Inui TS, Louie PH, Gates CA, McCreedy BJ, Egan R, Grove T, Alexander S. Indeterminate Human Immunodeficiency Virus Type 1 Western Blots: Seroconversion Risk, Specificity of Supplemental Test, and an Algorithm for Evaluation. Journal of Infectious Diseases 164:656-64,1991.
15. Burke DS, Redfield RR, Bjornson DC, Fowler AK, Oster CN. Frequent Isolation of HIV1 from the Blood of Patients Receiving Zidovudine (AZT) therapy. New England Journal of Medicine 321:1682,1989.

Address to correspondence.

Dr. C. Brites.

Laboratório de Retrovírus/HUPES/UFBA.

R. João das Botas s/n, Canela, 40110-160 Salvador, BA, Brazil.

Phone: (55 71) 235-4866, Fax (55-71) 245-7110.

Publication Dates

Publication in this collection
09 Apr 2013
Date of issue
Feb 1996

History

Accepted
08 Dec 1994
Received
08 Dec 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gurest J, Danguet C, Axler-Blin C, Brun-Vézinet F, Rozembaum W, Montagnier L. Isolation of a T-lymphotropic Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS). Science 220:868-71, 1983

[2] 2. Gallo RC, Sarin PS, Gelmann EH Robert-Guroff M, Richardson E, Kalyanaraman VS, Mann D, Sidhu GD, Stahl RE, Zolla-Paznes S, Leibowitch J, Popovic M. Isolation of Human T-Cell Leukemia Virus in Acquired Immune Deficiency Syndrome (AIDS). Science, 220:865-8 1983.

[3] 3. Gallo RC, Salahuddin SZ, Popovic M, Shearer GM, Kaplan M, Haynes BF, Palkert J, Redfield R, Oleske J, Safai B,White G, Foster P Markham PD. Frequent Detection and Isolation of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and at Risk of AIDS. Science 224:500-3, 1984.

[4] 4. Levy JA, Hoffman AD, Kramer SM, Landis JA, Schimabukuro JM, Oshiro LS. Isolation of Lymphocytopathic Retroviruses from San Francisco Patients with AIDS. Science 225:840-2, 1984,

[5] 5. Jackson JB, Coombs RW, Sannerud K, Rhame FS, Balfour HH Jr. Rapid and Sensitive Viral Culture Method for Human Immunodeficiency Virus Type 1. Journal of Clinicai Microbiology 26:1416-8, 1988.

[6] 6. Castro BA, Weiss CD.Wiviott LD, Levy JA. Optimal Conditions for Recovering Human Immunodeficiency Virus from Peripheral Blood Mononuclear Cells. Journal of Clinicai Microbiology 26:2371-6,1988.

[7] 7. Coombs RW; Collier AC; Allain JP; Nikora B; Leuther M; Gjerset GF; Corey L. Plasma viremia in Human Immunodeflciency Virus Infection. New England Journal of Medicine 321:1626-31,1989.

[8] 8. Ho DD, Moudgil T, Alam M. Quantitation of Human Immunodeficiency Virus Type 1 in the Blood of Infected Persons. New England Journal of Medicine 321:1621-1625,1989.

[9] 9. Ministério de Saúde. AIDS - Boletim Epidemiológico, ano VI, n° 08,1993.

[10] 10. Revision of the CDC Surveillance Case Definition for Acquired Immunodeflciency Syndrome. Mortality and Morbidity Weekly Report 36(suppl 1):38-158, 1987.

[11] 11. Spira TJ, Kaplan JE, Feorino PM, Warfield DT, Fishbein DB, Bozeman LH. Human Immunodeflciency Virus Viremia as a Prognostic Indicator in Homosexual Men with Lymphadenopathy Syndrome. New England Journal of Medicine 317:1093-4,1987.

[12] 12. Burke DS, Fowler AK, Redfield RR, Dilworth S, Oster CN. Isolation of HIV-1 from the Blood of Seropositive Adults: Patients Stage of Illness and Sample Inoculum Size are Major Determinants of a Positive Culture. Journal of Acquired Immune Deficiency Syndrome 3:1159-1167,1990.

[13] 13. Jackson JB, Mac Donald KL, Cadwell J, Sullivan C, Kline WE, Hanson M, Sannerud KJ, Stramer SL, Fildes NJ, Kwok SY. Absence of HIV Infection in Blood Donors with Indeterminate Western blot Test for Antibody to HIV1. New England Journal of Medicine 332:217-222,1990.

[14] 14. Celum CL, Coombs RW, Lafferty W., Inui TS, Louie PH, Gates CA, McCreedy BJ, Egan R, Grove T, Alexander S. Indeterminate Human Immunodeficiency Virus Type 1 Western Blots: Seroconversion Risk, Specificity of Supplemental Test, and an Algorithm for Evaluation. Journal of Infectious Diseases 164:656-64,1991.

[15] 15. Burke DS, Redfield RR, Bjornson DC, Fowler AK, Oster CN. Frequent Isolation of HIV1 from the Blood of Patients Receiving Zidovudine (AZT) therapy. New England Journal of Medicine 321:1682,1989.