HIV-1 plasma viral load assays by PCR are increasingly being used as a
surrogate marker to determine individual response to antiviral
medication, and in treatment decisions on altering such therapy.
Information/discussion is requested on the ability of viral load, as
currently measured in HIV-1 infection, to acurately reflect the
changes in viral population which may be expected under the influence
of RT inhibitors, protease inhibitors, NNRTI's and combinations of
these drugs.
If these agents alter viral production so that defective or
non-functional virions are produced, how would the current assays for
viral load reflect that?
If these agents alter viral production so that non-intact viral
particulate matter is produced instead of intact virions, how would
the current assays for viral load reflect this?
Insight into these questions is crucial to ensure correct management
of therapeutic decisions based on the viral load measure. Obviously,
this measure is redundant if it cannot differentiate between
functional and non-functional virions, or intact virions and particles
of viral components.
