title: Impact of HIV type 1 DNA levels on spontaneous disease progression: a meta-analysis.
abstract: Several studies have reported the prognostic strength of HIV-1 DNA with variable results however. The aims of the current study were to estimate more accurately the ability of HIV-1 DNA to predict progression of HIV-1 disease toward acquired immunodeficiency syndrome (AIDS) or death, and to compare the prognostic information obtained by HIV-1 DNA with that derived from plasma HIV-1 RNA. Eligible articles were identified through a comprehensive search of Medline, ISI Web of Science, Scopus, and Google Scholar. The analysis included univariate and bivariate random-effects models. The univariate meta-analysis of six studies involving 1074 participants showed that HIV-1 DNA was a strong predictive marker of AIDS [relative risk (RR): 3.01, 95% confidence interval (CI): 1.88-4.82] and of all-cause mortality (RR: 3.49, 95% CI: 2.06-5.89). The bivariate model using the crude estimates of primary studies indicated that HIV-1 DNA was a significantly better predictor than HIV-1 RNA of either AIDS alone (ratio of RRs=1.47, 95% CI: 1.05-2.07) or of combined (AIDS or death) progression outcomes (ratio of RRs=1.51, 95% CI: 1.11-2.05). HIV-1 DNA is a strong predictor of HIV-1 disease progression. Moreover, there is some evidence that HIV-1 DNA might have better predictive value than plasma HIV-1 RNA.
authors: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Greece.
authors: Chrissa G
authors: CG
authors: Tsiara
authors: Georgios K
authors: GK
authors: Nikolopoulos
authors: Pantelis G
authors: PG
authors: Bagos
authors: Cecile
authors: C
authors: Goujard
authors: Terese L
authors: TL
authors: Katzenstein
authors: Albert K
authors: AK
authors: Minga
authors: Christine
authors: C
authors: Rouzioux
authors: Angelos
authors: A
authors: Hatzakis
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000821:virology*; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load / Q000235:genetics
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D012367:RNA, Viral