Use of changes in plasma levels of human immunodeficiency virus type 1 RNA to assess the clinical benefit of antiretroviral therapy

J Infect Dis. 1998 Jan;177(1):40-7. doi: 10.1086/513823.

Abstract

Data from 1330 human immunodeficiency virus type 1 (HIV-1)-infected patients enrolled in seven antiretroviral treatment trials were analyzed to characterize the clinical benefit of treatment-mediated reductions in plasma HIV-1 RNA levels. The risk of a new AIDS-defining event or death was reduced proportionally to the magnitude of the reduction of the HIV-1 RNA level during the first 6 months of therapy. Pretherapy HIV-1 RNA levels were prognostic independently of on-therapy levels. In addition, the reduction in risk associated with any given reduction of the level of HIV-1 RNA did not vary by pretherapy level. Having either a reduction in HIV-1 RNA level or an increase in CD4+ lymphocyte count, or both, was associated with a delay in clinical disease progression. This indicates that patient prognosis should be assessed using both HIV-1 RNA and CD4+ lymphocyte responses to therapy.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / diagnosis
  • Acquired Immunodeficiency Syndrome / mortality
  • Acquired Immunodeficiency Syndrome / prevention & control
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Disease Progression
  • Double-Blind Method
  • Drug Monitoring
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV-1 / drug effects*
  • HIV-1 / isolation & purification
  • Humans
  • Male
  • Plasma / virology
  • Prognosis
  • RNA, Viral / analysis*
  • RNA, Viral / blood
  • RNA, Viral / isolation & purification
  • Retrospective Studies
  • Risk

Substances

  • Anti-HIV Agents
  • Antiviral Agents
  • RNA, Viral