Detection of circulating human immunodeficiency virus type 2 in plasma by reverse transcription polymerase chain reaction.
Genomic RNA was detected using a reverse transcription (RT) nested polymerase chain reaction (PCR) method on plasma from 24 HIV2-infected patients. Results were interpreted based on immune and clinical status and results of plasma and cellular viraemia assays. Amplification of RNA extracted from plasma was positive in 13 of the 24 cases studied (54%). There was a negative correlation between the detection of RNA in plasma and the patients' CD4+ cell counts: all 5 patients with counts below 200 x 10(6)/l were RT-PCR RNA-positive, compared to only 4 of the 12 patients with counts above 500 x 10(6)/l. Cellular viraemia was positive in 12 of the 24 patients, and the results correlated with the CD4+ cell count. HIV2 was isolated from the plasma of 3 of the 24 patients, all of whom had CD4+ cell counts below 200 x 10(6)/l. The small viral load in HIV2-infected patients before the onset of immunodeficiency appeared to be a major limiting factor in the detection of the virus with current tests. The low percentage of RNA-positive plasma samples contrasts with the high rate of positivity in HIV1-infected patients. Differences in viral load and replication between HIV1 and HIV2 correlate with differences in the epidemiology and pathogenicity of the two viruses.