Wood Karen L, Chaiyarit Ponlatham, Day Richard B, Wang Yana, Schnizlein-Bick Carol T, Gregory Richard L, Twigg Homer L
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Chest. 2003 Aug;124(2):536-42. doi: 10.1378/chest.124.2.536.
The lung is a common site of disease in HIV infection. Virus has been detected in BAL fluid (BALF) and saliva. However, the relationship between viral loads detected at different levels of the respiratory tract is unknown.
We measured simultaneous HIV viral loads in parotid saliva (PS), bronchial fluid (BF), BALF, and plasma by reverse transcription polymerase chain reaction in 20 HIV-infected individuals.
HIV was detected in 53% of BALF samples, 15% of BF samples, 5% of PS samples, and 88% of plasma samples. Viral loads in plasma and BALF samples were positively correlated. There were significantly higher levels of HIV viral load in both plasma and BALF in subjects with CD4 counts of < 200 cells/ microL compared to those with higher counts. Antiretroviral therapy (ART) was associated with lower BALF and plasma viral loads, and the effect in BALF was independent of the plasma viral load. Interestingly, smoking also was associated with lower levels of both BAL and BF viral loads, independent of the plasma viral load.
These data demonstrate that while HIV can be detected in the respiratory tract, the viral load is influenced by both local factors (ie, level of the respiratory tree and cigarette smoking) and systemic factors (ie, ART and peripheral CD4 count).
肺部是HIV感染中常见的病变部位。已在支气管肺泡灌洗液（BALF）和唾液中检测到病毒。然而，在呼吸道不同水平检测到的病毒载量之间的关系尚不清楚。
我们通过逆转录聚合酶链反应对20名HIV感染个体的腮腺唾液（PS）、支气管液（BF）、BALF和血浆中的HIV病毒载量进行了同步测量。
在53%的BALF样本、15%的BF样本、5%的PS样本和88%的血浆样本中检测到HIV。血浆和BALF样本中的病毒载量呈正相关。与CD4细胞计数较高的受试者相比，CD4细胞计数<200个/微升的受试者血浆和BALF中的HIV病毒载量显著更高。抗逆转录病毒疗法（ART）与较低的BALF和血浆病毒载量相关，且对BALF的影响独立于血浆病毒载量。有趣的是，吸烟也与较低的BAL和BF病毒载量相关，且独立于血浆病毒载量。
这些数据表明，虽然HIV可在呼吸道中检测到，但其病毒载量受局部因素（即呼吸道树的水平和吸烟）和全身因素（即ART和外周CD4细胞计数）的影响。
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