title: Fluctuations in HIV-1 viral load are correlated to CD4+ T-lymphocyte count during the natural course of infection.
abstract: Viral load fluctuates during the natural course of asymptomatic HIV-1 infection. It is often assumed that these fluctuations are random around a set point or underlying growth trend. Using longitudinal data, we tested whether fluctuations in viral load can be better explained by changes in CD4+ T-cell count than by a set point or trend of exponential growth. The correspondence between viral load and CD4+ T-cell count could be described by a simple mathematical relation. Using a bootstrapping approach, the hypothesis that viral load fluctuations are random around a set point was rejected with p < .00005. The hypothesis that viral load fluctuations are random around a trend of exponential growth was rejected with p < .005. Viral load data was explained better by changes in CD4+ T-cell counts than by a set point or by a trend of exponential growth. The implications of this finding for improved prognostication are discussed.
authors.affiliation: Wellcome Trust Centre for the Epidemiology of Infectious Disease, Department of Zoology, University of Oxford, UK.
authors.forename: J
authors.initials: J
authors.lastname: Masel
authors.forename: R A
authors.initials: RA
authors.lastname: Arnaout
authors.forename: T R
authors.initials: TR
authors.lastname: O'Brien
authors.forename: J J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: A L
authors.initials: AL
authors.lastname: Lloyd
mesh_terms: D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008297:Male; D008432:Mathematical Computing; D019562:Viral Load