Relationships among the detection of p24 antigen, human immunodeficiency virus (HIV) RNA level, CD4 cell count, and disease progression in HIV-infected individuals with hemophilia.
The aim of this study was to assess the relationships among the detection of p24 antigen, human immunodeficiency virus (HIV) RNA level, CD4 cell count, and disease progression in 111 males with hemophilia who were infected with HIV for < or =20 years. Sixty-four individuals (58%) developed p24 antigenemia a median of 11.6 years after seroconversion. The time to first detection of p24 antigen was shorter among those who were older (P=.04) and those with a high initial HIV RNA level (P=.006). The median HIV RNA level and CD4 cell count at the time of the detection of p24 antigen were 4.95 log(10) copies/mL and 100 cells/mm(3), respectively. In univariate analyses, p24 antigenemia was associated with more-rapid progression to AIDS (relative hazard [RH], 5.50; P=.0001). The effect was reduced (RH, 1.85; P=.06) after adjusting for CD4 cell counts and HIV RNA levels during follow-up, age, and calendar year. A significant relationship between p24 antigenemia and death was nonsignificant after adjusting for CD4 cell count.
Sabin
C A
CA
Department of Primary Care and Population Sciences, Royal Free Centre for HIV Medicine, Royal Free and University College Medical School, Rowland Hill St., London NW3 2PF, United Kingdom. c.sabin@pcps.ucl.ac.uk
Lepri
A C
AC
Devereux
H
H
Phillips
A N
AN
Loveday
C
C
Lee
C A
CA
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D002648:Child; D018450:Disease Progression; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood*; D013997:Time Factors; D019562:Viral Load
D016655:HIV Core Protein p24; D012367:RNA, Viral