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

JV Giorgi, RH Lyles, JL Matud… - JAIDS Journal of …, 2002 - journals.lww.com
JV Giorgi, RH Lyles, JL Matud, TE Yamashita, JW Mellors, LE Hultin, BD Jamieson
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2002journals.lww.com
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 …
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.
Lippincott Williams & Wilkins