title: Alternatives to HIV-RNA and CD4 count to monitor HIV disease progression: a prospective cohort study in Romania.
abstract: Little evidence exists on how to efficiently and effectively monitor HIV-disease progression in developing countries. Better understanding regarding cost-effective tests may help to resolve questions regarding treatment. A prospective cohort study was conducted with a 1-year follow-up period. Immune complex-dissociated (ICD) p24 antigen (ICD p24Ag), alone or in combination with HIV p24 antibody (p24Ab), was compared to HIV-RNA and CD4+ count in a cohort of 160 HIV-infected adolescents in Romania. The main outcome measure was disease progression, defined as >50,000 copies/ml of HIV-RNA or death. Among the 160 adolescents, a higher mean ICD p24Ag was significantly associated with clinical disease classification (CDC), plasma HIV-RNA concentration, and p24Ab. Multivariate logistic regression showed detectable ICD p24Ag had an odds ratio of 3.7 (95% CI 1.4-9.7) for disease progression in comparison to undetectable ICD p24Ag. ICD p24Ag is of value in determining the prognosis of disease in HIV-1-infected adolescents in developing countries. Additional studies for validation of this assay for HIV clades primarily affecting developing countries, are now needed.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA. kozinetz@bcm.tmc.edu
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Kozinetz
authors.forename: Rodica
authors.initials: R
authors.lastname: Matusa
authors.forename: Simona
authors.initials: S
authors.lastname: Ruta
authors.forename: Carl S
authors.initials: CS
authors.lastname: Hacker
authors.forename: Costin
authors.initials: C
authors.lastname: Cernescu
authors.forename: Andreea
authors.initials: A
authors.lastname: Cazacu
mesh_terms: D000293:Adolescent; D018791:CD4 Lymphocyte Count; D002648:Child; D018450:Disease Progression; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D016655:HIV Core Protein p24 / Q000097:blood* / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D012383:Romania; D012680:Sensitivity and Specificity
chemical_list: D015483:HIV Antibodies; D016655:HIV Core Protein p24; D012367:RNA, Viral