title: Variability and prognostic values of virologic and CD4 cell measures in human immunodeficiency virus type 1-infected patients with 200-500 CD4 cells/mm(3) (ACTG 175). AIDS Clinical Trials Group Protocol 175 Team.
abstract: Virologic measurements are increasingly used to evaluate prognosis and treatment responses in human immunodeficiency virus (HIV) type 1 infection. Markers of HIV-1 replication, including infectious HIV-1 titer from peripheral blood mononuclear cells, serum HIV-1 p24 antigen, plasma HIV-1 RNA, CD4 cell numbers, and viral syncytium-inducing (SI) phenotype, were determined in 391 virology substudy participants in AIDS Clinical Trials Group study 175. The subjects had 200-500 CD4 cells/mm3. All markers of viral replication significantly correlated with one another and were inversely related to CD4 cell number. Disease progression to an AIDS-defining event or death or loss of >50% of CD4 cells was associated with infectious HIV-1 titer (P < .001), HIV-1 RNA (P < .001), and HIV-1 p24 antigen (P = .007). In multivariate proportional hazards models, p24 antigen was never significant when HIV-1 RNA level was included. In a model containing infectious HIV-1 titer (P = .038), HIV-1 RNA (P < .001), SI phenotype (P < .001), and CD4 cell number (P = .18), only the virologic parameters remained significantly associated with progression.
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla 92093-0672, USA. jlathey@ucsd.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Lathey
authors.forename: M D
authors.initials: MD
authors.lastname: Hughes
authors.forename: S A
authors.initials: SA
authors.lastname: Fiscus
authors.forename: T
authors.initials: T
authors.lastname: Pi
authors.forename: J B
authors.initials: JB
authors.lastname: Jackson
authors.forename: S
authors.initials: S
authors.lastname: Rasheed
authors.forename: T
authors.initials: T
authors.lastname: Elbeik
authors.forename: R
authors.initials: R
authors.lastname: Reichman
authors.forename: A
authors.initials: A
authors.lastname: Japour
authors.forename: R T
authors.initials: RT
authors.lastname: D'Aquila
authors.forename: W
authors.initials: W
authors.lastname: Scott
authors.forename: B P
authors.initials: BP
authors.lastname: Griffith
authors.forename: S M
authors.initials: SM
authors.lastname: Hammer
authors.forename: D A
authors.initials: DA
authors.lastname: Katzenstein
mesh_terms: D018791:CD4 Lymphocyte Count; D003588:Cytopathogenic Effect, Viral; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality / Q000821:virology*; D015497:HIV-1; D006801:Humans; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D016655:HIV Core Protein p24; D012367:RNA, Viral