Plasma mitochondrial DNA levels are inversely associated with HIV-RNA levels and directly with CD4 counts: potential role as a biomarker of HIV replication

Berta Pernas, Ignacio Rego-Pérez, Andrés Tabernilla, Vanesa Balboa, Sara Relaño, Marta Grandal, Manuel Crespo, Álvaro Mena, Ángeles Castro-Iglesias, Francisco J Blanco, Eva Poveda

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5 Citations (Scopus)


OBJECTIVES: To evaluate plasma mitochondrial DNA (mtDNA) levels among HIV-infected patients and its potential role as a biomarker of residual viral replication.

METHODS: HIV-infected patients on follow-up at a reference hospital in north-west Spain were selected. DNA was isolated from plasma samples and mtDNA levels were assessed using a quantitative real-time PCR assay. HIV-RNA levels and CD4+ cell counts were evaluated in the same blood samples used for plasma mtDNA quantification. Epidemiological and clinical variables were included for the analysis.

RESULTS: A total of 235 HIV-infected patients were included. Mean plasma mtDNA levels were 217 ± 656 copies/μL for naive (31.9%) and 364 ± 939 copies/μL for HIV-infected patients receiving ART and with suppressed viraemia (P = 0.043). Among the latter, mean plasma mtDNA levels were 149 ± 440 copies/μL for those with low-level viraemia (LLV; HIV-RNA 20-200 copies/mL), 265 ± 723 copies/μL for those with detected-not-quantified (DNQ) viraemia (HIV-RNA <20 copies/mL) and 644 ± 1310 copies/μL for those with not-detected (ND) viraemia. Of note, a linear trend (P = 0.006) was observed among virologically suppressed (LLV, DNQ and ND) patients. ND patients had higher mtDNA levels compared with LLV patients (P = 0.057). Moreover, mtDNA levels were inversely associated with HIV-RNA levels (Spearman's rho -0.191, P = 0.003) and directly associated with CD4+ counts (Spearman's rho 0.131, P = 0.046).

CONCLUSIONS: Increased plasma mtDNA levels are associated with lower HIV-RNA levels and higher CD4+ cell counts. Among ART-suppressed patients, mtDNA levels were significantly higher in those with complete virological suppression (ND) than in those with LLV. These data suggest that plasma mtDNA levels might serve as a biomarker of residual HIV replication.

Original languageEnglish
Pages (from-to)3159-3162
Number of pages4
JournalThe Journal of antimicrobial chemotherapy
Issue number11
Publication statusPublished - 1 Nov 2017

Bibliographical note

© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email:


  • Adult
  • Biomarkers/blood
  • CD4 Lymphocyte Count
  • Cohort Studies
  • DNA, Mitochondrial/blood
  • Female
  • HIV Infections/epidemiology
  • HIV-1/genetics
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral/blood
  • Real-Time Polymerase Chain Reaction
  • Spain/epidemiology
  • Viral Load
  • Virus Replication


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