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. 1999 Nov 20;354(9192):1782-5.
doi: 10.1016/S0140-6736(99)02035-8.

Rapid production and clearance of HIV-1 and hepatitis C virus assessed by large volume plasma apheresis

B Ramratnam  1 , S Bonhoeffer, J Binley, A Hurley, L Zhang, J E Mittler, M Markowitz, J P Moore, A S Perelson, D D Ho
Affiliations

Rapid production and clearance of HIV-1 and hepatitis C virus assessed by large volume plasma apheresis

B Ramratnam et al. Lancet. .

Abstract

Background: In chronic HIV-1 infection, dynamic equilibrium exists between viral production and clearance. The half-life of free virions can be estimated by inhibiting virion production with antiretroviral agents and modelling the resulting decline in plasma HIV-1 RNA. To define HIV-1 and hepatitis C virus (HCV) dynamics, we used plasma apheresis to increase virion clearance temporarily while leaving virion production unaffected.

Methods: Plasma virus loads were measured frequently before, during, and after apheresis in four HIV-1-infected patients, two of whom were also co-infected with HCV. Rates of virion clearance were derived by non-linear least-square fitting of plasma virus load to a model of viral dynamics.

Findings: Virion clearance rate constants were 0.0063/min (9.1/day) to 0.025/min (36.0/day; half-life 28-110 min) for HIV-1 and 0.0038/min (5.5/day) to 0.0069/min (9.9/day; half-life 100-182 min) for HCV. These values provided estimates of daily particle production of 9.3 log10-10.2 log10 particles for HIV-1 and 11.6 log10-13.0 log10 particles for HCV.

Interpretation: Our findings confirm that HIV-1 and HCV are produced and cleared extremely rapidly. New estimates for HIV-1 clearance are up to ten times higher than previous ones, whereas HCV clearance is similar to previous estimates.

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