The Relationship Between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome: Executive Summary (Draft)

DRAFT

5. HIV can be detected in virtually all people with AIDS.
Recently developed testing methods, including the polymerase chain reaction
(PCR) and improved culture techniques, have enabled researchers to find HIV
in almost all patients with AIDS.
6. Virtually all people with AIDS have antibodies to HIV.
A recent survey of 230,179 cases diagnosed as AIDS initially revealed only 299
HIV-seronegative patients. An evaluation of 172 of these 299 patients found
that 131 were actually HIV-seropositive; an additional 34 had died before their
serostatus could be confirmed. Another 4 were shown to have some other form
of defined immunodeficiency.
7. Many studies show that only a single factor, HIV, predicts whether a
person will develop AIDS.
Other viral infections, bacterial infections, sexual behavior pattems, drug abuse
pattems, do not predict who develops AIDS. Individuals from diverse backgrounds, including heterosexual women, homosexual men, hemophiliacs,
sexual partners of hemophiliacs and transfusion recipients, and infants have all
developed AIDS, with the only common factor being their exposure to HIV.
8. Laboratory studies show that HIV infects and kills CD4+ T lymphocytes in
vitro.
CD4+ T cells are the same cells depleted in people with AIDS. Although the
loss of CD4+ T cells is not the only immune defect seen in AIDS, the fact that
HIV infects and damages these cells in vitro establishes a link between HIV and
AIDS.
9. Studies of HIV-infected patients show that increasing amounts of HIV in
the body correlate with the progression of the immunological processes
that lead to AIDS.
As levels of viral replication and the amount of virus in the body increase, so
too do the various immunological processes associated with AIDS. Recent
studies have shown that a rise in expression of HIV mRNA in peripheral blood
mononuclear cell precedes clinically defined progression of disease in people
with HIV.
In the approximately 5 percent of HIV-infected individuals whose disease does
not progress, the amount of virus in the blood and lymph nodes is significantly
lower than that in HIV-infected people whose disease progression is more
typical.

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