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

J Acquir Immune Defic Syndr. 2002 Apr 1;29(4):346-55. doi: 10.1097/00126334-200204010-00004.

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • ADP-ribosyl Cyclase
  • ADP-ribosyl Cyclase 1
  • Adult
  • Antigens, CD*
  • Antigens, Differentiation / metabolism*
  • Biomarkers
  • CD4 Lymphocyte Count
  • CD8-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / metabolism
  • Cohort Studies
  • Disease Progression
  • HIV Infections / immunology
  • HIV Infections / physiopathology*
  • HIV Infections / virology
  • HIV-1 / isolation & purification
  • HIV-1 / physiology*
  • Humans
  • Male
  • Membrane Glycoproteins
  • Middle Aged
  • NAD+ Nucleosidase / metabolism*
  • Predictive Value of Tests
  • Prognosis
  • RNA, Viral / blood*
  • Time Factors
  • Viral Load*

Substances

  • Antigens, CD
  • Antigens, Differentiation
  • Biomarkers
  • Membrane Glycoproteins
  • RNA, Viral
  • ADP-ribosyl Cyclase
  • CD38 protein, human
  • NAD+ Nucleosidase
  • ADP-ribosyl Cyclase 1