title: Heat-denatured human immunodeficiency virus type 1 protein 24 antigen: prognostic value in adults with early-stage disease.
abstract: CD4(+) lymphocyte count and human immunodeficiency virus (HIV) type 1 RNA level are useful for determining when to initiate antiretroviral therapy but are not used widely in developing countries due to the high cost. Heat-denatured protein 24 (p24) antigen is an inexpensive assay that predicts disease progression among persons with advanced disease but has not been assessed among persons with early-stage disease. Plasma levels of heat-denatured p24 antigen were quantified in baseline study-visit specimens obtained from injection drug users enrolled in a longitudinal cohort study of HIV-1 infection. Of the 494 study participants (median initial CD4(+) lymphocyte count, 518 lymphocytes/mm(3)), 90 (18%) progressed to acquired immunodeficiency syndrome within 5 years. p24 antigen level correlated with both CD4(+) lymphocyte count (r=-0.34; P<.0001) and HIV-1 RNA level (r=0.55; P<.0001). p24 antigen level >5 pg/mL predicted disease progression, comparable with that of cutoff CD4(+) lymphocyte count <350 lymphocytes/mm(3) and HIV-1 RNA level >30,000 copies/mL. Heat-denatured p24 antigen level predicted subsequent clinical disease progression in early-stage HIV-1 infection and correlated with both CD4(+) lymphocyte count and HIV-1 RNA level.
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000821:virology; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000032:analysis; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis* / Q000737:chemistry*; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology*; D015497:HIV-1 / Q000737:chemistry* / Q000502:physiology; D006358:Hot Temperature; D006801:Humans; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011489:Protein Denaturation; D012367:RNA, Viral / Q000032:analysis
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D016655:HIV Core Protein p24; D012367:RNA, Viral