Prospective longitudinal analysis of viral load and surrogate markers in relation to clinical progression in HIV type 1-infected persons

AIDS Res Hum Retroviruses. 1997 Mar 1;13(4):327-35. doi: 10.1089/aid.1997.13.327.

Abstract

The temporal relationship between viral and surrogate markers and clinical status was analyzed prospectively every 8 weeks in 34 asymptomatic HIV-1-infected persons. After 3 years, 25 persons remained clinically healthy whereas 9 persons showed clinical progression. In accordance with other reports we found that at study entry HIV-RNA load was predictive of clinical progression. All markers tested evolved significantly in time in both progressors and nonprogressors. The HIV RNA load in plasma and HIV DNA load in T cells were linearly related only in nonprogressors. In addition, the RNA/DNA ratio during follow-up was significantly higher in progressors, indicating a higher replication rate in progressors. The HIV DNA load correlated inversely with CD4+ T cell counts and positively with p24 antigenemia in both nonprogressors and progressors. A significant correlation of HIV DNA load with SI phenotype occurred in progressors only. HIV RNA levels correlated with beta 2-microglobulin level and with p24 antigenemia but not with SI phenotype. These three markers can all routinely be measured in plasma; however, only the HIV RNA levels appear to be informative for clinical progression. Six to 8 months before clinical progression, an SI phenotype switch, increased HIV RNA in plasma, and decreased CD4+ T cell counts were all indicative of an impending clinical event.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / cytology*
  • Disease Progression
  • Follow-Up Studies
  • HIV Core Protein p24 / blood*
  • HIV Infections / blood
  • HIV Infections / immunology
  • HIV Infections / virology*
  • HIV-1* / genetics
  • HIV-1* / immunology
  • Humans
  • Longitudinal Studies
  • Matched-Pair Analysis
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • RNA, Viral
  • Time Factors
  • beta 2-Microglobulin / analysis*

Substances

  • HIV Core Protein p24
  • RNA, Viral
  • beta 2-Microglobulin