Meta-analysis of antiretroviral effects on HIV-1 RNA, CD4 cell count and progression to AIDS or death

Antivir Ther. 1998;3(3):139-45.

Abstract

There is uncertainty as to how the effects of antiretroviral treatments on human immunodeficiency virus type 1 (HIV-1) RNA levels and CD4 cell counts can predict reductions in clinical progression to AIDS or death. A meta-analysis was conducted for 27 pairwise comparisons of antiretroviral treatments in 15 randomized trials of antiretroviral treatments. For each trial, three measures of treatment effect were used: (i) 16 week change from baseline in HIV-1 RNA; (ii) 16 week change from baseline in CD4 cell count; and (iii) rate of clinical progression. Treatments which caused greater increases in CD4 cell count and greater reductions in HIV-1 RNA were more effective at reducing the rate of clinical progression (P < 0.05 for each comparison). However, there was variability in the consistency of this correlation between different trials and treatments. The results support the use of both CD4 count and HIV-1 RNA levels as the primary markers of the efficacy of antiretroviral treatment.

Publication types

  • Meta-Analysis

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / virology
  • Anti-HIV Agents / therapeutic use*
  • CD4 Lymphocyte Count*
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • Humans
  • RNA, Viral / analysis*

Substances

  • Anti-HIV Agents
  • RNA, Viral