Western blot profiles, lymph node ultrastructure and viral expression in HIV-infected patients: a correlative study.

Sequential immunoblotting was performed on 64 patients infected with human immunodeficiency virus (HIV). Antibody profiles were related to immune function, T subsets and clinical features. In 20 patients, lymph node biopsy revealed a relationship between progressive follicular destruction, low antibody titres and ultrastructural evidence of viral replication and accumulation. Retroviral particles, including budding profiles, were confined to labyrinths formed from hypertrophied follicular dendritic (FD) cells; in some cases, including those with AIDS, the labyrinths showed degenerative changes. The demonstration of high antibody levels in asymptomatic patients with an intact FD cell network and low virion load suggests that antibody may have a protective role in vivo. Analysis of lymph node ultrastructure allows assessment of viral load and FD cell morphology. When combined with immunoblotting, it may be possible to improve prognostic stratification of patients with HIV infection.