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.
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.
Lathey
J L
JL
Department of Pediatrics, University of California, San Diego, La Jolla 92093-0672, USA. jlathey@ucsd.edu
Hughes
M D
MD
Fiscus
S A
SA
Pi
T
T
Jackson
J B
JB
Rasheed
S
S
Elbeik
T
T
Reichman
R
R
Japour
A
A
D'Aquila
R T
RT
Scott
W
W
Griffith
B P
BP
Hammer
S M
SM
Katzenstein
D A
DA
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
D016655:HIV Core Protein p24; D012367:RNA, Viral