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Sheldon H. Landesman, MD; David Burns, MD, MPH

JAMA. 1996;275(8):640-641.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Recent studies on the dynamics of human immunodeficiency virus type 1 (HIV-1) replication have enhanced our understanding of disease pathogenesis. It is now clear that even during the period of clinical latency there is continual highlevel viral replication, CD4⁺ lymphocyte infection, cell death, and new CD4⁺ cell production.^1-4 The magnitude of the viral and CD4⁺ cell turnover is extraordinary; on average, 10⁸ to 10⁹ HIV-1 virions and approximately the same number of CD4⁺ cells are produced and destroyed each day.^3,4 This process takes place primarily in the lymphoid tissue where the virus, though bound to a follicular dendritic cell and coated with neutralizing antibody, remains highly infectious to CD4⁺ T cells.⁵ The discovery of a persistently high level of viral turnover suggests that sensitive measurements of viral burden (reflecting rapid or unchecked viral replication) may be useful in assessing HIV disease stage, disease progression, response . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Infectious Disease, Department of Medicine, State University of New York Health Science Center at Brooklyn (Dr Landesman), and the Pediatric Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Md (Dr Burns).

Footnotes
This article does not necessarily represent the opinion of the US Public Health Service.

Reprint requests to the Division of Infectious Disease, Department of Medicine, State University of New York Health Science Center at Brooklyn, 450 Clarkson Ave, Box 122, Brooklyn, NY 11203 (Dr Landesman).

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