Bush C E, Donovan R M, Markowitz N P, Kvale P, Saravolatz L D
Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Sep;13(1):23-6. doi: 10.1097/00042560-199609000-00004.
We examined the effect of bacterial pneumonia on the magnitude of circulating plasma HIV RNA in HIV-infected patients. Serum samples from 13 adult HIV-infected patients (median CD4 count = 83 cells/microl) were assayed for HIV RNA using the reverse transcriptase polymerase chain reaction assay (a) before bacterial pneumonia, (b) during the acute phase, and (c) after the recovery from the disease. Patients remained on constant antiretroviral therapy: HIV RNA was detected in all samples tested. The medians before, during, and after bacterial pneumonia were 60,000 copies per ml, 245,000 copies per ml, and 84,000 copies per ml, respectively. All 13 patients had increased HIV RNA levels on developing pneumonia. There was a decline in the level of HIV RNA with recovery from pneumonia in 12 of 13 patients. The difference between the HIV RNA levels before and after pneumonia was not significant, nor was there significant difference in the CD4 counts before and after pneumonia. In conclusion, bacterial pneumonia is associated with a consistent, transient increase in HIV RNA of variable magnitude in AIDS patients. Interpretation of HIV RNA changes for clinical management of AIDS patients must take into account this reversible elevation during infections.
我们研究了细菌性肺炎对HIV感染患者循环血浆HIV RNA水平的影响。对13例成年HIV感染患者（CD4计数中位数 = 83个细胞/微升）的血清样本，使用逆转录聚合酶链反应检测法在以下三个阶段检测HIV RNA：(a)细菌性肺炎发生前；(b)急性期；(c)疾病恢复后。患者持续接受抗逆转录病毒治疗：所有检测样本均检测到HIV RNA。细菌性肺炎发生前、期间和之后的中位数分别为每毫升60,000拷贝、245,000拷贝和84,000拷贝。所有13例患者在发生肺炎时HIV RNA水平均升高。13例患者中有12例在肺炎恢复后HIV RNA水平下降。肺炎前后的HIV RNA水平差异无统计学意义，肺炎前后的CD4计数也无显著差异。总之，细菌性肺炎与艾滋病患者HIV RNA出现幅度不一的持续、短暂升高有关。在对艾滋病患者进行临床管理时，解读HIV RNA变化必须考虑到感染期间这种可逆性升高。
