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To the Editor: Using an ultrasensitive reverse transcriptase polymerase chain reaction (RT-PCR) analytical method, Dr Dornadula and colleagues¹ found that human immunodeficiency virus type 1 (HIV-1) RNA (mean level, 17 copies/mL) was detectable in blood plasma of all 22 patients who had previously received suppressive highly active antiretroviral therapy (HAART) and who were found to have fewer than 50 copies/mL of plasma HIV-1 RNA by standard assays.

However, it is possible that even this ultrasensitive method could not distinguish the presence of viable HIV-1 live viruses from nonviable, albeit persisting, HIV-1 viral residues persisting after HAART. For instance, the finding of bacterial antigens in cerebrospinal fluid (CSF) of patients with bacterial meningitis^2-3 or the detection of cryptococcal antigen in the CSF of patients with cryptococcal meningitis,⁴ or a positive VDRL test result or fluorescent treponemal antibody absorption test in serum or CSF of patients with infectious syphilis^5-6 may not necessarily . . . [Full Text of this Article]

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Residual HIV-1 RNA in Blood Plasma of Patients Taking Suppressive Highly Active Antiretroviral Therapy
Geethanjali Dornadula, Hui Zhang, Bonnie VanUitert, John Stern, Lawrence Livornese, Jr, Mark J. Ingerman, James Witek, Richard J. Kedanis, Jaan Natkin, Joseph DeSimone, and Roger J. Pomerantz
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