Prognostic value of plasma human immunodeficiency virus type 1 (HIV-1) RNA levels in patients with advanced HIV-1 disease and with little or no prior zidovudine therapy

S. L. Welles*, J. B. Jackson, B. Yen-Lieberman, L. Demeter, A. J. Japour, L. M. Smeaton, V. A. Johnson, D. R. Kuritzkes, R. T. D'Aquila, P. A. Reichelderfer, D. D. Richman, R. Reichman, M. Fischl, R. Dolin, R. W. Coombs, J. O. Kahn, C. McLaren, J. Todd, S. Kwok, C. S. Crumpacker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

The association of plasma human immunodeficiency virus type 1 (HIV-1) RNA level at study entry and over time with clinical progression was evaluated in 187 patients from AIDS Clinical Trials Group protocol 116A who had little or no prior zidovudine treatment. Three-fold-higher HIV-1 RNA levels at study entry and 3-fold increases by week 8 were associated with progression (relative hazard [RH], 1.67; 95% confidence limits [CL], 1.20, 2.32; and RH, 1.45; CL, 1.02, 2.05, respectively). Having 3-fold-higher CD4 cell count at entry was independently associated with a 52% reduction in risk for progression (adjusted RH, 0.48; CL, 0.33, 0.70). When stratified by length of prior zidovudine therapy, RNA level was predictive in drug-naive patients (adjusted RH, 1.87; CL, 1.23, 2.85) but not predictive in patients with up to 16 weeks of prior therapy (adjusted RH, 1.11; CL, 0.70, 1.76). Analysis suggests that the acquisition of mutations at HIV-1 reverse transcriptase codons 215 and 74 is associated with subsequent increases in HIV-1 RNA level (relative risk, 7.00; CL, 0.86, 56.90).

Original languageEnglish (US)
Pages (from-to)696-703
Number of pages8
JournalJournal of Infectious Diseases
Volume174
Issue number4
DOIs
StatePublished - 1996

Funding

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

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