title: Plasma viral load, CD4 cell percentage, HLA and survival of HIV-1, HIV-2, and dually infected Gambian patients.
abstract: OBJECTIVE
  To examine baseline plasma viral loads according to the CD4 cell percentage (CD4%) in HIV-1, HIV-2 and dually infected patients (HIV-D), and to relate these measurements to survival.
  
  
  METHODS
  A total of 119 HIV-1, 137 HIV-2 and 81 HIV-D-infected patients attending the Medical Research Council clinic in The Gambia were recruited from 1991 according to baseline CD4%, and followed until death or the end of December 2000. HIV-1 and HIV-2 RNA levels were measured by in-house reverse transcriptase polymerase chain reaction assays.
  
  
  RESULTS
  The plasma viral load, which varied inversely with CD4%, was similar in HIV-1 singly and dually infected patients, but was significantly higher in HIV-1 than in HIV-2 singly infected patients, except in those with a CD4% less than 14%. HIV-2 plasma viral load in dually infected patients did not vary significantly with CD4%, but was significantly lower than in HIV-2 singly infected patients with CD4% less than 14%. Multivariate analysis showed that only CD4% was independently associated with survival in HIV-1 and HIV-D infections; whereas both CD4% and plasma viral load were independently associated with survival in HIV-2 infections. The mortality rate of HIV-D-infected patients was not significantly different from that of HIV-1-infected patients, but was significantly higher in the absence of HLA B58.
  
  
  CONCLUSIONS
  HIV-2 infection does not alter HIV-1 replication or prolong survival in dually infected patients. In a clinical setting in Africa, where many patients present with advanced disease, CD4% may be a more important predictor of prognosis than plasma viral load.
authors.affiliation: Medical Research Council Laboratories, Banjul, The Gambia, West Africa.
authors.forename: Abraham S
authors.initials: AS
authors.lastname: Alabi
authors.forename: Shabbar
authors.initials: S
authors.lastname: Jaffar
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Tom
authors.initials: T
authors.lastname: Blanchard
authors.forename: Maarten
authors.initials: M
authors.lastname: Schim van der Loeff
authors.forename: Akum Aveika
authors.initials: AA
authors.lastname: Awasana
authors.forename: Tumani
authors.initials: T
authors.lastname: Corrah
authors.forename: Sehu
authors.initials: S
authors.lastname: Sabally
authors.forename: Ramu
authors.initials: R
authors.lastname: Sarge-Njie
authors.forename: Fatim
authors.initials: F
authors.lastname: Cham-Jallow
authors.forename: Assan
authors.initials: A
authors.lastname: Jaye
authors.forename: Neil
authors.initials: N
authors.lastname: Berry
authors.forename: Hilton
authors.initials: H
authors.lastname: Whittle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D005714:Gambia; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality / Q000821:virology*; D015497:HIV-1 / Q000235:genetics; D015498:HIV-2 / Q000235:genetics; D015235:HLA-B Antigens / Q000032:analysis*; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D013223:Statistics as Topic; D015996:Survival Rate; D019562:Viral Load
chemical_list: D015235:HLA-B Antigens; D012367:RNA, Viral