Relationship between load of virus in alveolar macrophages from human immunodeficiency virus type 1-infected persons, production of cytokines, and clinical

The level of human immunodeficiency virus type 1 (HIV-1) in lymphocytes and mononuclear phagocytes (MP) from the blood and pulmonary alveoli from 14 HIV-I-infected subjects during early (asymptomatic) and late (AIDS) stages of disease and the relationship between virus burden in MP and cytokine expression were assessed. Among asymptomatic subjects, HIV-I was unde-tectable or low in both blood monocytes and alveolar macrophages (AM). Among subjects with AIDS, there was a significant increase of HIV-1 in AM but not monocytes. The level of HIV-1 in blood lymphocytes was higher than in either monocytes or AM. AM (but not monocytes) ex-pressed increased levels of lipopolysaccharide-stimulated cytokine mRNA (tumor necrosis fac-tor-a, interleukin-I{3, interleukin-6) during both early and late stages of HIV-1 infection regard-less of virus load. AM thus may serve as a reservoir for virus in late stages of disease yet contribute to the immunopathogenesis of lung disease in both early and late stages through increased cytokine expression. The predominant cellular targets of human immunodefi-ciency virus type I (HIV-I) are CD4+ T lymphocytes (re-viewed in [I, 2]) and mononuclear phagocytes (MP) such a