Predictive value of immunologic and virologic markers after long or short duration of HIV-1 infection

Janis V. Giorgi, Robert H. Lyles, Jose L. Matud, Traci E. Yamashita, John W. Mellors, Lance E. Hultin, Beth D. Jamieson*, Joseph B. Margolick, Charles R. Rinaldo, John P. Phair, Roger Detels

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

206 Scopus citations

Abstract

Laboratory markers that predict HIV-1 disease progression include plasma viral burden, CD4+ T-cell count, and CD38 expression on CD8 T cells. To better understand whether the predictive value of these markers is dependent on how long an individual has been infected, we analyzed data from the Multicenter AIDS Cohort Study early (median = 2.8 years) and late (median = 8.7 years) in the course of infection. Overall, we found that HIV RNA and CD38 levels were similarly predictive of AIDS early on compared with a relatively weaker CD4 cell count signal. Later in the course of infection, CD38 level remained the strongest predictive marker and CD4 cell count registered a marked increase in prognostic power. Among untreated individuals, there was little difference in prognosis (median time to AIDS) associated with given marker values regardless of infection duration. The prognosis given a specific viral load level tended to deteriorate late in the course of infection among those undergoing treatment with monotherapy or combination therapy, however. These data provide a unique historical look at the predictive value and prognostic significance of HIV-1 disease markers at different stages of infection in a large cohort, with direct relevance to current patients who are untreated or for whom treatment is ineffective.

Original languageEnglish (US)
Pages (from-to)346-355
Number of pages10
JournalJournal of Acquired Immune Deficiency Syndromes
Volume29
Issue number4
DOIs
StatePublished - Apr 1 2002

Keywords

  • AIDS
  • CD38
  • CD4 cell counts
  • Disease stage
  • HIV RNA load
  • Prognosis

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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