Titre du document / Document title

Quantitative HIV-1 RNA as a marker of clinical stability and survival in a cohort of 302 patients with a mean CD4 cell count of 300×10⁶/I

Auteur(s) / Author(s)

RUIZ L. ⁽¹⁾ ; ROMEU J. ⁽²⁾ ; CLOTET B. ⁽²⁾ ; BALAGUE M. ⁽²⁾ ; CABRERA C. ⁽¹⁾ ; SIRERA G. ⁽²⁾ ; IBANEZ A. ⁽¹⁾ ; MARTINEZ-PICADO J. ⁽¹⁾ ; RAVENTOS A. ⁽²⁾ ; TURAL C. ⁽²⁾ ; SEGURA A. ⁽²⁾ ; FOZ M. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Retrovirology Laboratory, Institut de Recerca de la SIDA-Caixa, Hospital Universitari Germans Trias i Pujol Badalona, Universitat Autònoma de Barcelona, ESPAGNE
⁽²⁾ AIDS Care Unit, Department of Internal Medicine, Universitari Germans Trias i Pujol Badalona, Universitat Autònoma de Barcelona, ESPAGNE

Résumé / Abstract

Objective : To analyse plasma HIV-1 RNA levels as a marker of clinical stability and survival in a cohort of HIV-infected patients whose time of seroconversion is unknown. Design : Retrospective cohort study. Setting : Retrovirology laboratory and AIDS Unit in a teaching hospital. Patients : A total of 916 samples from 302 patients, most on antiretroviral therapy, were analysed. Mean initial CD4 cell counts and HIV-1 RNA were 299x10⁶/l (range : 0-1600) and 134 261 copies/ml (range : < 200-4 300 000), respectively. Sixty-six cases had been diagnosed previously with AIDS. Methods : Analysis of progression to AIDS and survival, according to initial and longitudinal viral load (VL) and CD4 cell count measurements was performed by Kaplan-Meier test. Relative risks were calculated by Cox's proportional hazards model. Results : During a mean follow-up of 444 ± 309 days, 29 patients developed AIDS and 21 died. Relative risk (RR) of progression related to the group with VL < 35 000 was : 10.4 when CD4 ≥ 250x10⁶/l and VL ≥ 35 000 (P 0.001) ; and 45.3 when CD4 < 250x10⁶/l and VL ≥ 35 000 (P < 0.0001). Cumulative probability of progression was : 0%, 0% and 12.3%, at the first, second and third year respectively, for patients with all their sequential VL determinations < 60 000 ; and 13.3%, 34.7% and 79.3% for patients who did not maintain VL values always < 60 000 (RR = 23 ; P < 0.0001). The minimum value of VL that reached statistical significance for the survival analysis was 100 000 copies/ml (P < 0.0001). Conclusions : VL ≥ or < 35 000 is a better discriminant for progression than a CD4 cell count ≥ or < 250x10⁶/1. Sequential VL determinations < 60 000 are associated with a better prognosis.

Revue / Journal Title

AIDS   ISSN 0269-9370 

Source / Source

1996, vol. 10, n^o11, pp. F39-F44 (16 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1987) (Revue)

Mots-clés anglais / English Keywords

AIDS ; HIV-1 virus ; Biological marker ; Evolution ; Prognosis ; Blood plasma ; Quantitative analysis ; RNA ; Survival ; Human ; Viral disease ; Infection ; Human immunodeficiency virus ; Lentivirinae ; Retroviridae ; Virus ; Immunopathology ; Immune deficiency ;

Mots-clés français / French Keywords

SIDA ; Virus HIV1 ; Marqueur biologique ; Evolution ; Pronostic ; Plasma sanguin ; Analyse quantitative ; RNA ; Survie ; Homme ; Virose ; Infection ; Virus immunodéficience humaine ; Lentivirinae ; Retroviridae ; Virus ; Immunopathologie ; Immunodéficit ;

Mots-clés espagnols / Spanish Keywords

SIDA ; HIV-1 virus ; Marcador biológico ; Evolución ; Pronóstico ; Plasma sanguíneo ; Análisis cuantitativo ; RNA ; Sobrevivencia ; Hombre ; Virosis ; Infección ; Human immunodeficiency virus ; Lentivirinae ; Retroviridae ; Virus ; Inmunopatología ; Inmunodeficiencia ;

Localisation / Location

INIST-CNRS, Cote INIST : 22094, 35400006606470.0010