The prognostic value of plasma viremia in HIV-infected patients under AZT treatment: a two-year follow-up study.
To determine the prognostic value of plasma viremia in long-term zidovudine (AZT)-treated HIV-infected patients, HIV-1 plasma viremia (PV) was quantified in 28 HIV-infected patients before and during AZT long-term treatment; the follow-up also included p24 antigenemia and CD4 cell counts. The variations of these markers during the follow-up period, the correlation with the clinical outcome (progressors versus nonprogressors), and the discrepancies between PV and surrogate markers were then analyzed. A significant and stable decrease in PV titer was observed in only nonprogressors (Friedman test, p < 0.005). At the end of follow-up, 11 (73%) of the 15 non-progressors were PV responders (patients who remained or became PV- long-term), whereas all the 13 progressors were PV nonresponders (patients who remained or became PV+). These results indicated a strong correlation between PV and clinical outcome (Fischer's exact test, p < 0.0001). The persistence, increase, or reappearance of viral replication appeared to be an important predictor of poor clinical outcome in HIV-infected patients under AZT treatment. This finding could provide a rational basis to help the clinician's decision in the clinical treatment of HIV-infected patients.
Ruffault
A
A
Laboratoire de Virologie, Hôpital Pontchaillou, Rennes, France.
Michelet
C
C
Jacquelinet
C
C
Guist'hau
O
O
Genetet
N
N
Bariou
C
C
Colimon
R
R
Cartier
F
F
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D018791:CD4 Lymphocyte Count; D005260:Female; D005500:Follow-Up Studies; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D014766:Viremia / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D014779:Virus Replication; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use*
D016655:HIV Core Protein p24; D015215:Zidovudine