Recent studies on the dynamics of human immunodeficiency virus type 1 (HIV-1) replication have enhanced our understanding of disease pathogenesis. It is now clear that even during the period of clinical latency there is continual highlevel viral replication, CD4+ lymphocyte infection, cell death, and new CD4+ cell production.1-4 The magnitude of the viral and CD4+ cell turnover is extraordinary; on average, 108 to 109 HIV-1 virions and approximately the same number of CD4+ cells are produced and destroyed each day.3,4 This process takes place primarily in the lymphoid tissue where the virus, though bound to a follicular dendritic cell and coated with neutralizing antibody, remains highly infectious to CD4+ T cells.5 The discovery of a persistently high level of viral turnover suggests that sensitive measurements of viral burden (reflecting rapid or unchecked viral replication) may be useful in assessing HIV disease stage, disease progression, response
Landesman SH, Burns D. Quantifying HIV. JAMA. 1996;275(8):640–641. doi:10.1001/jama.1996.03530320064036
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