Opportunistic events and p17 expression in the bone marrow of human immunodeficiency virus-infected patients.

Bone marrow biopsies from 114 human immunodeficiency virus (HIV)-infected patients were stained with an anti-p17 monoclonal antibody to detect active HIV replication and associated factors. Immunoreactive p17 was found as virus-like particles in macrophages and dendritic cells and occasionally in megakaryocytes in 62 of 114 marrows and was considered evidence of active HIV replication. Immunoreactive p17 was not found significantly more often in the marrows of patients with lower CD4 cell counts; however, it was found significantly more in the marrows of patients with concurrent mycobacterial or fungal infections or lymphoma (chi 2 = 12.1, P < .001). Immunoreactive p17 was even more frequent when these opportunistic diseases were found in the biopsied marrow (chi 2 = 20.5, P < .001). The association of active HIV replication with certain opportunistic diseases, but not with lower CD4 cell counts, raises the possibility that these opportunistic diseases may under some circumstances be a cause as well as a consequence of active HIV replication.