Romeu J, Ruiz L, Balague M, Cabrera C, Tural C, Puig T, Sirera G, Raventos A, Clotet B; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1996 Sep 15-18; 204 (abstract no. I100).
HIV Unit and Retrovirology Laboratory "irsi Caixa", Hospital Universitari Germans Trias I Pujol, Badalona, Spain.
HIV-1 RNA plasma levels have proved to be an important tool to monitorize HIV-1 infected pts. We analyzed viral load (VL) and CD4 cell count values as predictors of progression to AIDS and mortality. We studied 302 pts from all stages of infection. More than one sample was available from 243 pts. Mean CD4 cell counts and RNA HIV-1 plasma copies in the first determination were 299/mm(3) (range: 0-1600; SD; 259.4) and 134, 261 copies/ml (range: less than 200-4, 3x10(6), SD: 4, 1x10(5)). Sixty-six cases had already developed AIDS when the first sample was obtained. Most of the pts (255; 84%) received antiretroviral therapy (greater than 1 month). Forty-three pts (14.2%) were naive. During a mean follow-up of 436 plus or minus 304 days (15-1128), 29 pts were diagnosed of AIDS and 20 died. Analysis of clinical progression and survival was performed by the Kaplan-Meier test. Relative risk were calculated by the Cox's Proportional Hazards model. Relative risk of progression related to the group with CD4 greater than or equal to 300 and VL less than 37,500 was: 1.3 when CD4 less than 300 and VL less than 37,500 (p=0.72); 4.8 when CD4 greater than or equal to 300 and VL greater than or equal to 37,500 (p=0.04); and 12.7 when CD4 less than 300 and VL greater than or equal to 37,500 (p is less than 0.0001). Cumulative probability of progression for pts with all their sequential VL determinations less than 55,000 was: 1.1%, 1.1%, and 9.4%, at the first, second and third years respectively. Conversely, pts who did not maintain VL values always less than 55,000 had a cumulative probability of progression of 11.2%, 33.1% and 80%; (RR=20; 95% CI 4.7-85.7; p is less than 0.0001). The minimum value of VL that reached statistical significance for the survival analysis was 10,000 c/ml (p is less than 0.05). VL greater than or equal to or less than 37,500 is a better discriminant for progression than a CD4 cell count greater than or equal to or less than 300/mm(3). Sequential VL determinations less than 55,000 copies/ml should be a goal in HIV infection management because this value is associated with a better prognosis.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antigens, CD4
- Biological Markers
- CD4 Lymphocyte Count
- Disease Progression
- HIV Infections
- HIV-1
- Health Personnel
- Humans
- Prognosis
- Proportional Hazards Models
- RNA
- RNA, Viral
- Survival Analysis
- Viral Load
- epidemiology
- immunology
- mortality
Other ID:
UI: 102235049
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