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

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


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • DNA, Viral / blood
  • HIV Infections / metabolism
  • HIV Infections / virology*
  • HIV-1 / isolation & purification*
  • HIV-1 / metabolism
  • Half-Life
  • Hepacivirus / isolation & purification*
  • Hepacivirus / metabolism
  • Humans
  • Metabolic Clearance Rate
  • Models, Theoretical
  • Plasmapheresis*
  • RNA, Viral / blood
  • Virion / growth & development*


  • DNA, Viral
  • RNA, Viral