title: Serum levels of human immunodeficiency virus type 1 (HIV-1) RNA after seroconversion: a predictor of long-term mortality in HIV infection.
abstract: A cohort of 79 homosexual men with documented dates of human immunodeficiency virus type 1 (HIV-1) seroconversion and baseline CD4 cell counts of > or = 500/microL were followed for up to 11.5 years. HIV-1 RNA was measured from stored sera obtained a median of 7 months after the estimated seroconversion date. AIDS progression and mortality among the men were studied, stratified by median baseline levels of HIV-1 RNA. AIDS progression rates at 11.5 years were 69% and 34%, respectively, among those with higher versus lower than median baseline virus loads (> or = 3040 copies/mL; P = .002), and mortality rates were 61% and 27%, respectively (P = .003). Survival curves continued to diverge throughout the 11.5 years, suggesting that the future clinical course of HIV-1 infection may already be determined at the earliest phases of disease. Initiation of definitive treatment very early in HIV-1 infection may be essential.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
authors.forename: K J
authors.initials: KJ
authors.lastname: Craib
authors.forename: S A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: R S
authors.initials: RS
authors.lastname: Hogg
authors.forename: B
authors.initials: B
authors.lastname: Leung
authors.forename: J S
authors.initials: JS
authors.lastname: Montaner
authors.forename: M V
authors.initials: MV
authors.lastname: O'Shaughnessy
authors.forename: M T
authors.initials: MT
authors.lastname: Schechter
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000097:blood / Q000401:mortality* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood*; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors
chemical_list: D012367:RNA, Viral