Early Identification of Human Immunodeficiency Virus-Infected Asymptomatic Subjects Susceptible to Zidovudine by Quantitative Viral Coculture and Reverse Transcription-Linked Polymerase Chain Reaction

The effect of zidovudine (500 mg/day) on 32 asymptomatic subjects seropositive for human immunodeficiency virus (HIV) was evaluated by monitoring the concentrations of infections HIV-carrying blood mononuclear cells and serum virus particles. After 3 months of treatment, a significant reduction in cellular virus load (P < .001) and a marginal decrease in serum viremia (P = .068) were noted. After 6 months, 14 patients (44%) maintained a > or = 50% reduction in virus load, 12 patients (37%) had a virus load that declined by > 50% at 3 months but returned to the initial level at 6 months, and 6 patients (19%) retained their initial virus load. Thus, virus load measurements permit reliable follow-up of antiviral therapy on an individual basis and may enable the identification of patients for whom zidovudine is efficacious.