Prognostic value of plasma HIV RNA among highly active antiretroviral therapy users

Patrick M. Tarwater*, Joel E. Gallant, John W. Mellors, Mary E. Gore, John P. Phair, Roger Detels, Joseph B. Margolick, Alvaro Muñoz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background: The study objective was to compare the prognostic value of plasma HIV RNA and CD4 cell count at baseline and as time-updated variables in highly active antiretroviral therapy (HAART) users for two outcomes: development of AIDS and change in CD4 cell count. Methods: The study population comprised 387 men enrolled in the Multicenter AIDS Cohort Study who were AIDS-free and initiated HAART between 1996 and 2001. Follow-up until AIDS diagnosis (n=36, 9%) or the last AIDS-free visit was included. To determine the predictive value of combining HIV RNA and CD4 cell count, regression tree methods using recursive partitioning at pre-specified cut points for both variables were used. Results: Low CD4 cell count was a strong predictor of AIDS among HAART users. However, HIV RNA showed strong prognostic value for AIDS development among those with CD4 cell counts > 250 × 106 cells/l, in whom an HIV RNA level > 1000 copies/ml carried a 4.6-fold greater risk of developing AIDS. HIV RNA < 5000 copies/ml was also predictive of subsequent increase in CD4 cell count with significantly higher increases among those with initial CD4 counts > 300 × 106 cells/l. Conclusion: Although, in HAART users, CD4 cell count was the primordial prognostic marker, an HIV RNA > 1000 copies/ml attained after HAART initiation was a strong predictor of the rate of subsequent CD4 cell count increase and of developing AIDS in patients whose CD4 cell counts were > 250 × 106 cells/l.

Original languageEnglish (US)
Pages (from-to)2419-2423
Number of pages5
Issue number18
StatePublished - Dec 3 2004

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


Dive into the research topics of 'Prognostic value of plasma HIV RNA among highly active antiretroviral therapy users'. Together they form a unique fingerprint.

Cite this