title: Correlation between plasma HIV-1 RNA levels and the rate of immunologic decline.
abstract: To determine the influence of HIV-1 replication on immunologic decline and clinical outcome, we quantified the HIV-1 plasma viral load in 20 patients at different times over a mean period of 10.8 months. Quantitation was performed by branched DNA signal amplification (bDNA) and p24 antigenemia. Immunologic status was assessed through beta 2-microglobulin and CD4+ cell count determinations. CD4+ cell decline was expressed as a slope of the regression line constructed by the logarithms of CD4+ cell count observations. Mean values of plasma viral load were correlated with CD4+ cell decline and mean beta 2-microglobulin levels. Significant correlation was observed between plasma viral load quantified by the bDNA technique and CD4+ cell decline. No significant correlation was observed between plasma viral load quantified by p24 antigenemia and CD4+ cell decline. A significant correlation was observed between plasma viral load and beta 2-microglobulin levels. Immunologic decline was better predicted from HIV-1 RNA levels than from the CD4+ cell count. Significantly higher plasma viral load was observed in patients who had clinical progression of HIV-1 infection. Thus, HIV-1 plasma viral load quantified by a highly reliable technique such as bDNA showed that the immunologic decline is closely related to HIV-1 RNA replication.
authors.affiliation: Department of Biomedicine, University of Pisa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Iuliano
authors.forename: G
authors.initials: G
authors.lastname: Forastieri
authors.forename: M
authors.initials: M
authors.lastname: Brizzi
authors.forename: L
authors.initials: L
authors.lastname: Mecocci
authors.forename: F
authors.initials: F
authors.lastname: Mazzotta
authors.forename: L
authors.initials: L
authors.lastname: Ceccherini-Nelli
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D016049:Didanosine / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D015497:HIV-1 / Q000235:genetics* / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D012367:RNA, Viral / Q000097:blood*; D018119:Stavudine / Q000627:therapeutic use; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy / Q000276:immunology*; D014779:Virus Replication / Q000276:immunology*; D016047:Zalcitabine / Q000627:therapeutic use; D015215:Zidovudine / Q000627:therapeutic use; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D016655:HIV Core Protein p24; D012367:RNA, Viral; D001613:beta 2-Microglobulin; D015215:Zidovudine; D016047:Zalcitabine; D018119:Stavudine; D016049:Didanosine