Natural history of human immunodeficiency virus type 1 viremia after seroconversion and proximal to AIDS in a large cohort of homosexual men. Multicenter AIDS Cohort Study.
The natural history of human immunodeficiency virus type 1 (HIV-1) viremia and its association with clinical outcomes after seroconversion was characterized in a cohort of homosexual men. HIV-1 RNA was measured by reverse-transcription polymerase chain reaction (RT-PCR) in stored longitudinal plasma samples from 269 seroconverters. Subjects were generally antiretroviral drug naive for the first 3 years after seroconversion. The decline in CD4 lymphocyte counts was strongly associated with initial HIV RNA measurements. Both initial HIV RNA levels and slopes were associated with AIDS-free times. Median slopes were +0.18, +0.09, and -0.01 log10 copies/mL, respectively, for subjects developing AIDS <3, 3-7, and>7 years after seroconversion. In contrast, HIV RNA slopes in the 3 years preceding AIDS and HIV RNA levels at AIDS diagnosis showed little variation according to total AIDS-free time. HIV RNA load at the first HIV-seropositive visit ( approximately 3 months after seroconversion) was highly predictive of AIDS, and subsequent HIV RNA measurements showed even better prognostic discrimination.
Lyles
R H
RH
Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.
Muñoz
A
A
Yamashita
T E
TE
Bazmi
H
H
Detels
R
R
Rinaldo
C R
CR
Margolick
J B
JB
Phair
J P
JP
Mellors
J W
JW
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000821:virology*; D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D015497:HIV-1 / Q000302:isolation & purification*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000276:immunology / Q000821:virology*
D012367:RNA, Viral