The relative prognostic value of plasma HIV RNA levels and CD4 lymphocyte counts in advanced HIV infection
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The relative prognostic value of plasma HIV RNA levels and CD4 lymphocyte counts in advanced HIV infection. / Cozzi-Lepri, A; Katzenstein, T L; Ullum, H; Phillips, A N; Skinhøj, P; Gerstoft, J; Pedersen, Bente Klarlund.
In: AIDS (London, England), Vol. 12, No. 13, 10.09.1998, p. 1639-43.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The relative prognostic value of plasma HIV RNA levels and CD4 lymphocyte counts in advanced HIV infection
AU - Cozzi-Lepri, A
AU - Katzenstein, T L
AU - Ullum, H
AU - Phillips, A N
AU - Skinhøj, P
AU - Gerstoft, J
AU - Pedersen, Bente Klarlund
PY - 1998/9/10
Y1 - 1998/9/10
N2 - OBJECTIVE: It has been suggested that the plasma HIV RNA level is a better predictor of AIDS and death than the CD4 lymphocyte count. We assessed whether the prognostic value of plasma virus levels was different according to the CD4 count.DESIGN: Prospective cohort study of HIV-infected patients followed for a median of 2.91 years (range, 0.02-4.54).SETTING: Department of Infectious Diseases at Rigshospitalet, Copenhagen, Denmark.PARTICIPANTS: A group of 255 HIV-infected individuals with an initial measurement of CD4 lymphocyte count and plasma HIV RNA.MAIN OUTCOME MEASURE: Survival time.RESULTS: The plasma HIV RNA (median 101410 copies/ml; range (range 200-7200000) and the CD4 lymphocyte count (median 250 cells x 10(6)/l; range 1-1247) were negatively correlated (Pearson r = -0.53; P < 0.00001). Of the 255 patients, 110 died during follow-up. Overall, a higher HIV RNA level was associated with increased risk of death, but the association was smaller in patients with lower CD4 lymphocyte counts (test for interaction P < 0.0001). In patients with CD4 count below 50 cells x 10(6)/l the association between HIV RNA and risk of death was not statistically significant (relative hazard per 10-fold higher HIV RNA level was 1.53; P = 0.11; adjusted for age and CD4 count) while that between the CD4 count and risk of death was highly significant (relative hazard per 50% lower CD4 count 1.38; P = 0.005; adjusted for age and HIV RNA level).CONCLUSIONS: Patients were relatively lightly treated with antiretroviral drugs both before and during this study. In this situation, it appears that the HIV RNA level has a relatively weak association with risk of death in patients with advanced HIV infection and that the CD4 lymphocyte count is probably more useful in assessing prognosis.
AB - OBJECTIVE: It has been suggested that the plasma HIV RNA level is a better predictor of AIDS and death than the CD4 lymphocyte count. We assessed whether the prognostic value of plasma virus levels was different according to the CD4 count.DESIGN: Prospective cohort study of HIV-infected patients followed for a median of 2.91 years (range, 0.02-4.54).SETTING: Department of Infectious Diseases at Rigshospitalet, Copenhagen, Denmark.PARTICIPANTS: A group of 255 HIV-infected individuals with an initial measurement of CD4 lymphocyte count and plasma HIV RNA.MAIN OUTCOME MEASURE: Survival time.RESULTS: The plasma HIV RNA (median 101410 copies/ml; range (range 200-7200000) and the CD4 lymphocyte count (median 250 cells x 10(6)/l; range 1-1247) were negatively correlated (Pearson r = -0.53; P < 0.00001). Of the 255 patients, 110 died during follow-up. Overall, a higher HIV RNA level was associated with increased risk of death, but the association was smaller in patients with lower CD4 lymphocyte counts (test for interaction P < 0.0001). In patients with CD4 count below 50 cells x 10(6)/l the association between HIV RNA and risk of death was not statistically significant (relative hazard per 10-fold higher HIV RNA level was 1.53; P = 0.11; adjusted for age and CD4 count) while that between the CD4 count and risk of death was highly significant (relative hazard per 50% lower CD4 count 1.38; P = 0.005; adjusted for age and HIV RNA level).CONCLUSIONS: Patients were relatively lightly treated with antiretroviral drugs both before and during this study. In this situation, it appears that the HIV RNA level has a relatively weak association with risk of death in patients with advanced HIV infection and that the CD4 lymphocyte count is probably more useful in assessing prognosis.
KW - Adult
KW - Aged
KW - Biomarkers
KW - CD4 Lymphocyte Count
KW - Cohort Studies
KW - Female
KW - Follow-Up Studies
KW - HIV
KW - HIV Infections
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Proportional Hazards Models
KW - RNA, Viral
KW - Viral Load
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
M3 - Journal article
C2 - 9764783
VL - 12
SP - 1639
EP - 1643
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 13
ER -
ID: 180572264