title: Meta-analysis of antiretroviral effects on HIV-1 RNA, CD4 cell count and progression to AIDS or death.
abstract: There is uncertainty as to how the effects of antiretroviral treatments on human immunodeficiency virus type 1 (HIV-1) RNA levels and CD4 cell counts can predict reductions in clinical progression to AIDS or death. A meta-analysis was conducted for 27 pairwise comparisons of antiretroviral treatments in 15 randomized trials of antiretroviral treatments. For each trial, three measures of treatment effect were used: (i) 16 week change from baseline in HIV-1 RNA; (ii) 16 week change from baseline in CD4 cell count; and (iii) rate of clinical progression. Treatments which caused greater increases in CD4 cell count and greater reductions in HIV-1 RNA were more effective at reducing the rate of clinical progression (P < 0.05 for each comparison). However, there was variability in the consistency of this correlation between different trials and treatments. The results support the use of both CD4 count and HIV-1 RNA levels as the primary markers of the efficacy of antiretroviral treatment.
authors.affiliation: GlaxoWellcome, Greenford, Middlesex, UK. AMH21137@GGR.CO.UK
authors.forename: A M
authors.initials: AM
authors.lastname: Hill
authors.forename: R
authors.initials: R
authors.lastname: DeMasi
authors.forename: D
authors.initials: D
authors.lastname: Dawson
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D012367:RNA, Viral / Q000032:analysis*
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral