title: AIDS onset at high CD4+ cell levels is associated with high HIV load.
abstract: To identify factors associated with development of AIDS at high CD4+ cell levels a nested case-control study using data from the Multicenter AIDS Cohort Study (MACS) was conducted. HIV-1-infected men who developed AIDS with > or =300/mm3 CD4+ cells (AIDS men) were compared to men who had > or =300/mm3 of CD4+ cells, but remained AIDS free for at least 2 years. The AIDS men had higher plasma HIV-1 RNA levels (mean 10(5.02) vs. 10(4.42), p<0.01) and neopterin levels (mean 18.3 vs. 11.5 units/ml, p<0.05) before the AIDS diagnosis than did the AIDS-free men. A significantly higher proportion of the AIDS men reported genital herpes within the year prior to their initial AIDS diagnosis than did the AIDS-free men (21.9 vs. 4.4%, p<0.05). The higher viral load at relatively high CD4+ cell levels in men who subsequently developed AIDS within 6 months supports the hypothesis that elevated levels of HIV precede CD4+ decline and are the major factor in determining risk of AIDS even at high levels of CD4+ cell levels.
authors.affiliation: Los Angeles Center of the Multicenter AIDS Cohort Study, Department of Epidemiology, UCLA School of Public Health, California, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Hennessey
authors.forename: J V
authors.initials: JV
authors.lastname: Giorgi
authors.forename: A H
authors.initials: AH
authors.lastname: Kaplan
authors.forename: B R
authors.initials: BR
authors.lastname: Visscher
authors.forename: S
authors.initials: S
authors.lastname: Gange
authors.forename: J B
authors.initials: JB
authors.lastname: Margolick
authors.forename: S
authors.initials: S
authors.lastname: Riddler
authors.forename: J
authors.initials: J
authors.lastname: Phair
authors.forename: R
authors.initials: R
authors.lastname: Detels
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology* / Q000821:virology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology*; D016022:Case-Control Studies; D015497:HIV-1 / Q000472:pathogenicity*; D006558:Herpes Genitalis / Q000150:complications; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019798:Neopterin / Q000097:blood; D012367:RNA, Viral / Q000032:analysis; D018709:Statistics, Nonparametric; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D019798:Neopterin