Document 0294
 DOCN  M95B0294
 TI    Natural history of HIV-1 cell-free viremia.
 DT    9511
 AU    Henrard DR; Phillips JF; Muenz LR; Blattner WA; Wiesner D; Eyster ME;
       Goedert JJ; Department of Medical Research, Abbott Laboratories, North;
       Chicago, Ill., USA.
 SO    JAMA. 1995 Aug 16;274(7):554-8. Unique Identifier : AIDSLINE
       MED/95356346
 AB    OBJECTIVE--To characterize the natural history of viremia with human
       immunodeficiency virus type 1 (HIV-1) and its association with disease
       progression from infection to acquired immunodeficiency syndrome (AIDS).
       DESIGN--Prospective cohort study. Annual specimens were tested for
       quantitative virion-associated HIV-1 RNA, p24 antigen, and CD4+
       lymphocyte levels. PARTICIPANTS--A total of 42 homosexual men who
       seroconverted to HIV-1 between 1982 and 1985. MAIN OUTCOME
       MEASURES--Trends over time in serum HIV-1 RNA level, correlations
       between serum HIV-1 RNA and other markers, and prediction of AIDS using
       these markers. RESULTS--HIV-1 RNA levels were stable over time,
       increasing by 10-fold or more in only six (14%) of the 42 subjects
       during 3 to 11 years of follow-up. Mean HIV-1 RNA levels were 10(3.8)
       copies/mL if AIDS occurred in less than 4 years, 10(3.07) copies/mL if
       AIDS developed within 4 through 9 years, and 10(2.27) copies/mL if AIDS
       did not develop within 6 through 11 years. In both univariate and
       multivariate models, initial and subsequent HIV-1 RNA levels, p24
       antigenemia, and percentage of CD4+ lymphocytes were independently
       predictive of AIDS. CONCLUSIONS--The stability of virion-associated
       HIV-1 RNA levels suggests that an equilibrium between HIV-1 replication
       rate and efficacy of immunologic response is established shortly after
       infection and persists throughout the asymptomatic period of the
       disease. Thus, defective immunologic control of HIV-1 infection may be
       as important as the viral replication rate for determining AIDS-free
       survival. Because individual steady-state levels of viremia were
       established soon after infection, HIV-1 RNA levels may be useful markers
       for predicting clinical outcome.
 DE    Acquired Immunodeficiency Syndrome/*BLOOD/IMMUNOLOGY/MORTALITY  Adult
       Biological Markers/BLOOD  Cohort Studies  CD4 Lymphocyte Count  Disease
       Progression  Enzyme-Linked Immunosorbent Assay  Flow Cytometry  Human
       HIV Core Protein p24/ANALYSIS/*BLOOD  HIV
       Infections/BLOOD/*PHYSIOPATHOLOGY  *HIV-1/ISOLATION & PURIF/PHYSIOLOGY
       Longitudinal Studies  Male  Multivariate Analysis  Predictive Value of
       Tests  Prognosis  Proportional Hazards Models  Prospective Studies  RNA,
       Viral/ANALYSIS/*BLOOD  Support, U.S. Gov't, P.H.S.  Survival Analysis
       Viremia/BLOOD/*PHYSIOPATHOLOGY  Virus Replication  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).