Distinct changes in HIV type 1 RNA versus p24 antigen levels in serum during short-term zidovudine therapy in asymptomatic individuals with and without progression to AIDS.
Serum HIV-1 RNA and p24 antigen levels were examined in 28 seropositive asymptomatic individuals participating in a trial on the efficacy of zidovudine. Sixteen individuals remained asymptomatic until 4 years after the onset of the trial, whereas 12 individuals were diagnosed with an AIDS-defining event. The serum HIV-1 RNA load and p24 antigen levels were determined before the onset of therapy and during the first 8 weeks of therapy to establish whether the patterns of change were predictive of clinical outcome. Among the 28 participants 43% had measurable pretreatment concentrations of p24 antigen. Initiation of zidovudine therapy was followed by a similar decline of p24 antigen levels in nonprogressors as well as progressors and, therefore, these groups could not be distinguished on the basis of this parameter. HIV-1 RNA was detected in the pretreatment samples of 82% of the individuals and could be detected in p24 antigen-positive as well as p24 antigen-negative individuals. Similar changes in HIV-1 RNA load during zidovudine therapy were observed in p24 antigen-positive and -negative individuals. Analysis of the HIV-1 RNA response according to clinical outcome demonstrated that HIV-1 RNA copy numbers had declined significantly after 4 weeks of therapy in both nonprogressors and progressors, but the decline in RNA load was much stronger in the nonprogressors. Our data show that the HIV-1 RNA load in serum can be used to monitor the response to antiviral therapy in p24 antigen-positive as well as -negative individuals. Posttreatment changes in p24 antigen levels are not indicative for clinical outcome, whereas RNA copy numbers are.(ABSTRACT TRUNCATED AT 250 WORDS)
Jurriaans
S
S
Human Retrovirus Laboratory, Academic Medical Center, University of Amsterdam, The Netherlands.
Weverling
G J
GJ
Goudsmit
J
J
Boogaard
J
J
Brok
M
M
Van Strijp
D
D
Lange
J
J
Koot
M
M
Van Gemen
B
B
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology; D000328:Adult; D001483:Base Sequence; D017931:DNA Primers / Q000235:genetics; D004279:DNA, Viral / Q000235:genetics; D004311:Double-Blind Method; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D010641:Phenotype; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood* / Q000235:genetics; D013997:Time Factors; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use*
D017931:DNA Primers; D004279:DNA, Viral; D016655:HIV Core Protein p24; D012367:RNA, Viral; D015215:Zidovudine