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Introduction: With limited funds available, meeting global health targets requires countries to both mobilize and prioritize their health spending. Within this context, countries have recognized the importance of allocating funds for HIV as efficiently as possible to maximize impact. Over the past six years, the governments of 23 countries in Africa, Asia, Eastern Europe and Latin America have used the Optima HIV tool to estimate the optimal allocation of HIV resources. Methods: Each study commenced with a request by the national government for technical assistance in conducting an HIV allocative efficiency study using Optima HIV. Each study team validated the required data, calibrated the Optima HIV epidemic model to produce HIV epidemic projections, agreed on cost functions for interventions, and used the model to calculate the optimal allocation of available funds to best address national strategic plan targets. From a review and analysis of these 23 country studies, we extract common themes around the optimal allocation of HIV funding in different epidemiological contexts. Results and discussion: The optimal distribution of HIV resources depends on the amount of funding available and the characteristics of each country's epidemic, response and targets. Universally, the modelling results indicated that scaling up treatment coverage is an efficient use of resources. There is scope for efficiency gains by targeting the HIV response towards the populations and geographical regions where HIV incidence is highest. Across a range of countries, the model results indicate that a more efficient allocation of HIV resources could reduce cumulative new HIV infections by an average of 18% over the years to 2020 and 25% over the years to 2030, along with an approximately 25% reduction in deaths for both timelines. However, in most countries this would still not be sufficient to meet the targets of the national strategic plan, with modelling results indicating that budget increases of up to 185% would be required. Conclusions: Greater epidemiological impact would be possible through better targeting of existing resources, but additional resources would still be required to meet targets. Allocative efficiency models have proven valuable in improving the HIV planning and budgeting process. Keywords: HIV modeling; allocative efficiency; cost-effectiveness; optimal HIV investment; resource allocation; resource needs, 1 | INTRODUCTION If decisions on the allocation of health resources were guided by the principals of health economics alone, funds would be allocated in ways intended to lead to [...]

The shear viscosity and self-diffusion transport coefficient of xylene isomers using the OPLS set of parameters for substituted benzenes are calculated. Comparison with experimental results for density and viscosity shows that these properties can be well reproduced using this potential, and therefore it is assumed that the diffusion coefficients should be also accurate to the same degree.

It is well established that the Green–Kubo type of expression of the friction coefficient for a massive colloidal particle, i.e., the force autocorrelation integral, vanishes at long times if the liquid volume is finite. Here I show that the nonzero friction coefficient, defined as the ratio of force on the particle and the average liquid velocity, can be found in the framework of the linear response theory as the ratio of the force autocorrelation integral and the correlation integral of liquid velocity and force on the particle. The finite inverse friction coefficient can be alternatively expressed as the autocorrelation integral of the liquid velocity. [ABSTRACT FROM AUTHOR]

Vanishing of the equilibrium fluctuation expression for the friction coefficient of a massive particle in a finite-volume liquid has been well documented and discussed in literature. This paper investigates the decay of the friction force in the corresponding nonequilibrium situation, when the massive particle moves through a finite volume at a constant velocity. The friction force ultimately vanishes (with the decay form as predicted by the equilibrium integral) because of the finite mass of the rest of the system, which allows it to be dragged by the moving particle. However, it is sufficient to have two infinite masses moving relative to each other in a finite liquid volume for the friction force to be finite at all times. [ABSTRACT FROM AUTHOR]

We calculate viscosity and thermal conductivity in systems of Lennard–Jones particles consisting of coexisting solid and liquid with different interface wetting properties using the recently developed equilibrium boundary fluctuation theory. We compare the slip length and equivalent liquid length obtained from these calculations with those obtained from nonequilibrium molecular dynamics. The equilibrium and nonequilibrium calculations of the slip length and the sum of the thermal equivalent lengths are in good agreement. We conclude that for both interfacial properties, the nonequilibrium simulations were probing the linear response. The significant dependence of the intrinsic equivalence length on the interfacial temperature difference used to generate the thermal gradient is explained as a consequence of the different thermodynamic states of the two interfaces. [ABSTRACT FROM AUTHOR]

Shear flow in fluids confined between planar solid walls is conventionally simulated by moving the walls past each other at constant relative velocity. In infinite fluids (in periodic boundary conditions), it is simulated using one of the “synthetic” nonequilibrium algorithms (the so-called Sllod and Dolls algorithms). Here I formulate the boundary conditions for the motion of confining walls that make these three algorithms equivalent in the weak-field limit. [ABSTRACT FROM AUTHOR]

We demonstrate that the linear response theory of interface friction presented by Bocquet and Barrat [Phys. Rev. E 49, 3079 (1994)] results in a friction coefficient that is not an intrinsic property of the interface and thus does not correspond to the actual interfacial friction coefficient. We point out that this previous derivation includes an unsubstantiated identification of the velocity field in the nonuniform system with the perturbation applied to the equations of the motion. We present an alternative equilibrium theory of the friction associated with the confined fluid and show how this friction is related to the intrinsic interfacial friction. [ABSTRACT FROM AUTHOR]

We propose a phenomenological model for shear-induced melting aimed at assisting the design of experimental studies of this phenomenon. For increasing strain rates, the model predicts the changes in liquid fraction and shear stress as a function of interfacial supercooling. We discuss the experimental conditions under which shear-induced melting could be observed in a range of materials. [ABSTRACT FROM AUTHOR]

We present a method for the direct calculation at equilibrium of the shear viscosity and thermal conductivity over distances as short as one molecular diameter. The method is directly applicable to the calculation of viscosity and thermal conductivity in inhomogeneities such as the interface between coexisting phases. The method makes use of a novel extension of our recently developed boundary fluctuation theory. [ABSTRACT FROM AUTHOR]

In this paper we present, for the first time, a linear-response theory of transport coefficients—shear viscosity and thermal conductivity—involving thermal, as opposed to mechanical, fields. The theory involves the explicit treatment of the boundaries and the constraints that are applied to them. Expressions for the shear viscosity and thermal conductivity are obtained in terms of the fluctuations at the boundaries of the variable conjugate to that which is constrained. We explain how the choice of ensemble, as defined by the boundary constraints, determines the form in which the transport coefficients are evaluated. [ABSTRACT FROM AUTHOR]

We present a factorization of the Ewald sum permitting efficient computation of the reciprocal space part of the molecular representation for the heat flux vector. We use the derived expression to evaluate thermal conductivity of a model of ethanol at several near-ambient state points. [ABSTRACT FROM AUTHOR]

We use nonequilibrium molecular-dynamics (NEMD) simulations to characterize the response of a fluid subjected to an electric field. We focus on the response for very weak fields. Fields accessible by conventional NEMD methods are typically of the order of 109 V m-1, i.e., several orders of magnitude larger than those typically used in experiments. Using the transient time-correlation function, we show how NEMD simulations can be extended to study systems subjected to a realistic dc electric field. We then apply this approach to study the response of molten sodium chloride for a wide range of dc electric fields. [ABSTRACT FROM AUTHOR]

We study the dependence of viscosity of ethanol on shear rate using constant volume and constant pressure nonequilibrium molecular dynamics simulations, with the emphasis of the interrelationship between breaking, stability, and alignment of hydrogen bonds and shear thinning at high shear rates. We find that although the majority of hydrogen bond breakings occur at low shear rates, we do not observe shear thinning until there is some shear-induced alignment of the hydrogen bonds with the direction of shear. [ABSTRACT FROM AUTHOR]

We systematically investigate the cooperative effects in shear stress relaxation using equilibrium molecular-dynamics simulations in periodic boundary conditions containing a variable degree of strain. We show that, even in simple liquids, shear stress relaxation is a cooperative effect associated with a correlation length that increases with isobaric decrease in temperature. If the system size is less than the correlation length, shear stress in the system is determined by the boundary strain. Transport, however, does not depend on the boundary conditions. We relate these two effects to the number and properties of the configurations accessible to the system. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

We show that at high densities, as the system size decreases, liquid becomes able to permanently sustain increasing internal shear stress after a constant deformation, although the other characteristic liquid properties, such as the pair distribution function and diffusion coefficient do not change under strain. The system size necessary for observation of this effect increases with the decrease in temperature, and it is stronger in pair potentials with steeper repulsive part. We relate this result to the size of the “cooperatively rearranging regions” of the Adam–Gibbs theory of glass transition. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

We study the shear stress relaxation and temperature dependence of the diffusion coefficient, viscosity, and thermal conductivity along a high-density Lennard-Jones isochore of the reduced density of 1.0, as it crosses the freezing and melting lines, in equilibrium and under constant strain. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

We study the properties of molten sodium chloride in alternating electric fields of two amplitudes and for a large range of frequencies using nonequilibrium molecular dynamics simulations, and compare the responses with two different methods of temperature control to the predictions of linear response theory. We find that the considerable nonlinearity in the resulting current density observed at low frequencies can be explained by the characteristics of the nonlinear response to constant fields. We also comment on the differences in the dissipation mechanisms and the entropy change with two thermostats. © 2003 American Institute of Physics. [ABSTRACT FROM AUTHOR]

We investigate the influence of thermostatting methods on the electrical conductivity and structure of molten and supercritical sodium chloride obtained in nonequilibrium molecular dynamics simulations in strong constant (dc) electric fields. The strong dependence of the results on the type of thermostat employed in simulations becomes apparent only at extremely high fields (>0.5 × 10[sup 9] V/m). For this range of fields, quantitative differences of unexpected size can be seen in the melt. In the supercritical fluid, different thermostats predict qualitatively very different behavior and structure. While the kinetic-type thermostats predict increased association of ions in the field, configurational thermostat predicts enhanced dissociation. [ABSTRACT FROM AUTHOR]

The shear viscosity of molten sodium chloride is determined under a wide range of strain rates using nonequilibrium molecular dynamics (NEMD) simulations in the canonical (N,V,T) ensemble. Questions have been recently raised on the use of kinetic temperature thermostats, based on the equipartition principle, in simulations of nonequilibrium fluids and using a configurational temperature thermostat has been suggested to be more realistic. To further ascertain the results obtained in this work, we study molten NaCl with both kinetic and configurational temperature thermostats. Since configurational thermostats have been so far restricted to simple fluids or alkanes, we first apply configurational expressions for the temperature to molten NaCl, test the values so obtained in equilibrium molecular dynamics simulation for various system sizes and state points and finally use them to thermostat molten NaCl under shear. NEMD results obtained for both thermostats show that except for the so-called normal stress coefficients, molten salt under shear exhibits mostly the same features as a simple fluid under shear, i.e., features in agreement with the mode-coupling theory. The choice of the thermostatting method is found to have little influence on the results for the range of shear rates investigated. [ABSTRACT FROM AUTHOR]

The basic model of viral dynamics is a relatively simple set of equations describing the most essential features of the host–pathogen interactions. Coupled with data, it has been used extensively and successfully to reproduce and explain the features of the early acute phase of HIV infection and the effects of antiretroviral treatment, as well as to estimate the lifespan of infected cells, viral growth and clearance rates and predict early outcomes under different circumstances. However, it cannot reproduce the entire natural course of untreated HIV infection consistently with constant parameters. Here we show that it is possible to qualitatively reproduce the whole course of untreated HIV infection within the general framework of the basic model by assuming progressively declining viral clearance coupled with viral load. We discuss the interpretation of this model as proof-of-concept that may inspire further research into the role of viral clearance in HIV infection. The authors describe a simple coupling of free virus clearance to viral load in the basic model of viral dynamics that allows for the simulation of the whole course of untreated HIV infection. [ABSTRACT FROM AUTHOR]

Antiretroviral-free HIV remission requires substantial reduction of the number of latently infected cells and enhanced immune control of viremia. Latencyreversing agents (LRAs) aim to eliminate latently infected cells by increasing the rate of reactivation of HIV transcription, which exposes these cells to killing by the immune system. As LRAs are explored in clinical trials, it becomes increasingly important to assess the effect of an increased HIV reactivation rate on the decline of latently infected cells and to estimate LRA efficacy in increasing virus reactivation. However, whether the extent of HIV reactivation is a good predictor of the rate of decline of the number of latently infected cells is dependent on a number of factors. Our modeling shows that the mechanisms of maintenance and clearance of the reservoir, the life span of cells with reactivated HIV, and other factors may significantly impact the relationship between measures of HIV reactivation and the decline in the number of latently infected cells. The usual measures of HIV reactivation are the increase in cell-associated HIV RNA (CA RNA) and/or plasma HIV RNA soon after administration. We analyze two recent studies where CA RNA was used to estimate the impact of two novel LRAs, panobinostat and romidepsin. Both drugs increased the CA RNA level 3- to 4-fold in clinical trials. However, cells with panobinostat-reactivated HIV appeared long-lived (half-life > 1 month), suggesting that the HIV reactivation rate increased by approximately 8%. With romidepsin, the life span of cells that reactivated HIV was short (2 days), suggesting that the HIV reactivation rate may have doubled under treatment. [ABSTRACT FROM AUTHOR]

Aging-related decline in immunity is believed to be the main driver behind decreased vaccine efficacy and reduced resistance to infections in older adults. Unrepaired DNA damage is known to precipitate cellular senescence, which was hypothesized to be the underlying cause of certain age-related phenotypes. Consistent with this, some hallmarks of immune aging were more prevalent in individuals exposed to whole-body irradiation ( WBI), which leaves no anatomical repository of undamaged hematopoietic cells. To decisively test whether and to what extent WBI in youth will leave a mark on the immune system as it ages, we exposed young male C57 BL/6 mice to sublethal WBI (0.5-4 Gy), mimicking human survivor exposure during nuclear catastrophe. We followed lymphocyte homeostasis thorough the lifespan, response to vaccination, and ability to resist lethal viral challenge in the old age. None of the irradiated groups showed significant differences compared with mock-irradiated (0 Gy) animals for the parameters measured. Even the mice that received the highest dose of sublethal WBI in youth (4 Gy) exhibited equilibrated lymphocyte homeostasis, robust T- and B-cell responses to live attenuated West Nile virus ( WNV) vaccine and full survival following vaccination upon lethal WNV challenge. Therefore, a single dose of nonlethal WBI in youth, resulting in widespread DNA damage and repopulation stress in hematopoietic cells, leaves no significant trace of increased immune aging in a lethal vaccine challenge model. [ABSTRACT FROM AUTHOR]

Latently infected cells are considered a major barrier to the cure of HIV infection, since they are long-lived under antiretroviral therapy (ART) and cause viral replication to restart soon after stopping ART. In the last decade, different types of antilatency drugs have been explored with the aim of reactivating and purging this latent reservoir and the hope of achieving a cure. Because of toxicity and safety considerations, antilatency drugs can only be given for a short time to patients on long-term ART, with little effect. We recently investigated the turnover of latently infected cells during active infection and have found that it was strongly correlated with viral load. This implies that although latently infected cells had long life spans in a setting of a low viral load (such as during ART), they turned over quickly under a high viral load. Possible reasons for this could be that an increased viral load causes increased activation or death of CD4+ T cells, including those that are latently infected. Taking these results into account, we developed a mathematical model to study the most appropriate timing of antilatency drugs in relationship to the initiation of ART.We found that the best timing of a short-term antilatency drug would be the start of ART, when viral load, CD4+ T cell activation, and latent cell turnover are all high. These results have important implications for the design of HIV cure-related clinical trials. [ABSTRACT FROM AUTHOR]

Resting CD4+ T cells are a reservoir of latent HIV-1. Understanding the turnover of HIV DNA in these cells has implications for the development of eradication strategies. Most studies of viral latency focus on viral persistence under antiretroviral therapy (ART). We studied the turnover of SIV DNA resting CD4+ T cells during active infection in a cohort of 20 SIV-infected pigtail macaques. We compared SIV sequences at two Mane-A1*084:01-restricted CTL epitopes using serial plasma RNA and resting CD4+ T cell DNA samples by pyrosequencing, and used a mathematical modeling approach to estimate SIV DNA turnover. We found SIV DNA turnover in resting CD4+ T cells was slow in animals with low chronic viral loads, consistent with the long persistence of latency seen under ART. However, in animals with high levels of chronic viral replication, turnover was high. SIV DNA half-life within resting CD4 cells correleated with viral load (p = 0.0052) at the Gag KP9 CTL epitope. At a second CTL epitope in Tat (KVA10) there was a trend towards an association of SIV DNA half-life in resting CD4 cells and viral load (p = 0.0971). Further, we found that the turnover of resting CD4+ T cell SIV DNA was higher for escape during early infection than for escape later in infection (p = 0.0084). Our results suggest viral DNA within resting CD4 T cells is more labile and may be more susceptible to reactivation/eradication treatments when there are higher levels of virus replication and during early/acute infection. [ABSTRACT FROM AUTHOR]

Early studies of HIV infection dynamics suggested that virus-producing HIV-infected cells had an average half-life of approximately 1 day. However, whether this average behavior is reflective of the dynamics of individual infected cells is unclear. Here, we use HIV-enhanced green fluorescent protein (EGFP) constructs and flow cytometry sorting to explore the dynamics of cell infection, viral protein production, and cell death in vitro. By following the numbers of productively infected cells expressing EGFP over time, we show that infected cell death slows down over time. Although infected cell death in vivo could be very different, our results suggest that the constant decay of cell numbers observed in vivo during antiretroviral treatment could reflect a balance of cell death and delayed viral protein production. We observe no correlation between viral protein production and death rate of productively infected cells, showing that viral protein production is not likely to be the sole determinant of the death of HIV-infected cells. Finally, we show that all observed features can be reproduced by a simple model in which infected cells have broad distributions of productive life spans, times to start viral protein production, and viral protein production rates. This broad spectrum of the level and timing of viral protein production provides new insights into the behavior and characteristics of HIV-infected cells. [ABSTRACT FROM AUTHOR]

Background There is significant debate about whether the gut plays a major role in viral replication and pathology in HIV infection. Here we aimed to estimate the contribution of the gut to the total virus observed in plasma, by comparing the frequency of different viral mutants in plasma and gut in SIV infection. Results We found that the maximum contribution of gut to plasma viral load estimated from rectal biopsy at day 28 post-infection had a median of 10%. The estimated values for individual animals ranged from nearly 100% to <3% in 4/14 animals. Importantly, these are maximum estimates, so that a value of 90%, for example, means that the real contribution may be anything between 0 and 90%, just not higher than 90%. We also studied the contribution of gut at the peak of plasma viral load (day 14). However, since there was very little escape in most animals at this time point, we could only estimate the maximal contribution of gut in 4 animals, in two of which it was <15%. Conclusions The role of the gut in HIV is a controversial area, with many suggesting that it plays a dominant role in driving early infection. Our analysis suggests that, at least by day 28 postinfection, the gut is not contributing greatly to the plasma viral load. [ABSTRACT FROM AUTHOR]

Severe malaria occurs predominantly in young children and immunity to clinical disease is associated with cumulative exposure in holoendemic settings. The relative contribution of immunity against various stages of the parasite life cycle that results in controlling infection and limiting disease is not well understood. Here we analyse the dynamics of Plasmodium falciparum malaria infection after treatment in a cohort of 197 healthy study participants of different ages in order to model naturally acquired immunity. We find that both delayed time-to-infection and reductions in asymptomatic parasitaemias in older age groups can be explained by immunity that reduces the growth of blood stage as opposed to liver stage parasites. We found that this mechanism would require at least two components - a rapidly acting strain-specific component, as well as a slowly acquired cross-reactive or general immunity to all strains. Analysis and modelling of malaria infection dynamics and naturally acquired immunity with age provides important insights into what mechanisms of immune control may be harnessed by malaria vaccine strategists. [ABSTRACT FROM AUTHOR]

Persistence of HIV DNA presents a major barrier to the complete control of HIV infection under current therapies. Most studies suggest that cells with latently integrated HIV decay very slowly under therapy. However, it is much more difficult to study the turnover and persistence of HIV DNA during active infection. We have developed an "escape clock" approach for measuring the turnover of HIV DNA in resting CD4+ T cells. This approach studies the replacement of wild-type (WT) SIV DNA present in early infection by CTL escape mutant (EM) strains during later infection. Using a strain-specific real time PCR assay, we quantified the relative amounts of WT and EM strains in plasma SIV RNA and cellular SIV DNA. Thus we can track the formation and turnover of SIV DNA in sorted resting CD4+ T cells. We studied serial plasma and PBMC samples from 20 SIV-infected Mane-A*10 positive pigtail macaques that have a signature Gag CTL escape mutation. In animals with low viral load, WT virus laid down early in infection is extremely stable, and the decay of this WT species is very slow, consistent with findings in subjects on anti-retroviral medications. However, during active, high level infection, most SIV DNA in resting cells was turning over rapidly, suggesting a large pool of short-lived DNA produced by recent infection events. Our results suggest that, in order to reduce the formation of a stable population of SIV DNA, it will be important either to intervene very early or intervene during active replication. [ABSTRACT FROM AUTHOR]

Identifying early predictors of infection outcome is important for the clinical management of HIV infection, and both viral load and CD4+ T cell level have been found to be useful predictors of subsequent disease progression. Very high viral load or extensively depleted CD4+ T cells in the acute phase often result in failure of immune control, and a fast progression to AIDS. It is usually assumed that extensive loss of CD4+ T cells in the acute phase of HIV infection prevents the establishment of robust T cell help required for virus control in the chronic phase. We tested this hypothesis using viral load and CD4+ T cell number of SHIV-infected rhesus macaques. In acute infection, the lowest level of CD4+ T cells was a good predictor of later survival; animals having less than 3.3% of baseline CD4+ T cells progressed to severe disease, while animals with more than 3.3% of baseline CD4+ T cells experienced CD4+ T cell recovery. However, it is unclear if the disease progression was caused by early depletion, or was simply a result of a higher susceptibility of an animal to infection. We derived a simple relationship between the expected number of CD4+ T cells in the acute and chronic phases for a constant level of host susceptibility or resistance. We found that in most cases, the depletion of CD4+ T cells in chronic infection was consistent with the prediction from the acute CD4+ T cell loss. However, the animals with less than 3.3% of baseline CD4 T cells in the acute phase were approximately 20% more depleted late in the infection than expected based on constant level of virus control. This suggests that severe acute CD4 depletion indeed impairs the immune response. [ABSTRACT FROM AUTHOR]

Many studies have shown that vaccines inducing CD8+ T cell responses can reduce viral loads and preserve CD4+ T cell numbers in monkey models of HIV infection. The mechanism of viral control by the vaccine-induced CD8+ T cells is usually assumed to be cytolysis of infected cells. However, in addition to cytolysis of infected cells, CD8+ T cells secrete a range of soluble factors that suppress viral replication. We have studied the dynamics of virus and CD4+ T cells in a successful vaccination-challenge model of SHIV infection. We find that better viral control in the acute phase of infection is associated with slower decay of peak viral load. Comparing viral and CD4+ T cell dynamics in acute infection, we find that a cytolytic mode of viral control with direct killing of infected cells is inconsistent with the observed trends. On the other hand, comparison of the predicted effects of noncytolytic CD8+ effector function with the experimental data shows that noncytolytic control provides a better explanation of the experimental results. Our analysis suggests that vaccine-induced CD8+ T cells control SHIV infection by non-cytolytic means. [ABSTRACT FROM AUTHOR]

Successful vaccination against HIV should limit viral replication sufficiently to prevent the emergence of viral immune escape mutations. Broadly directed immunity is likely to be required to limit opportunities for immune escape variants to flourish. We studied the emergence of an SIV Gag cytotoxic T cell immune escape variant in pigtail macaques expressing the Mane-A*10 MHC I allele using a quantitative RT-PCR to measure viral loads of escape and wild type variants. Animals receiving whole Gag expressing vaccines completely controlled an SIVmac251 challenge, had broader CTL responses and exhibited minimal CTL escape. In contrast, animals vaccinated with only a single CTL epitope and challenged with the same SIVmac251 stock had high levels of viral replication and rapid CTL escape. Unvaccinated naïve animals exhibited a slower emergence of immune escape variants. Thus narrowly directed vaccination against a single epitope resulted in rapid immune escape and viral levels equivalent to that of naïve unvaccinated animals. These results emphasize the importance of inducing broadly directed HIV-specific immunity that effectively quashes early viral replication and limits the generation of immune escape variants. This has important implications for the selection of HIV vaccines for expanded human trials. [ABSTRACT FROM AUTHOR]

The acute phases of human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) infection are characterized by rapid and profound depletion of CD4+ cells from the guts of infected individuals. The large number of CD4+ cells in the gut (a large fraction of which are activated and express the HIV/SIV coreceptor CCR5), the high level of infection of these cells, and the temporal coincidence of this CD4+ T-cell depletion with the peak of virus in plasma in acute infection suggest that the intestinal mucosa may be the major source of virus driving the peak viral load. Here, we used data on CD4+-cell proportions in the lamina propria of the rectums of SIV-infected rhesus macaques (which progress to AIDS) and sooty mangabeys (which do not progress) to show that in both species, the depletion of CD4+ cells from this mucosal site and its maximum loss rate are often observed several days before the peak in viral load, with few CD4+ cells remaining in the rectum by the time of peak viral load. In contrast, the maximum loss rate of CD4+ cells from bronchoalveolar lavage specimens and lymph nodes coincides with the peak in virus. Analysis of the kinetics of depletion suggests that, in both rhesus macaques and sooty mangabeys, CD4+ cells in the intestinal mucosa are a highly susceptible population for infection but not a major source of plasma virus in acute SIV infection. [ABSTRACT FROM AUTHOR]