Clinical prognosis of patients with early-stage human immunodeficiency virus (HIV) disease: Contribution of HIV-1 RNA and T lymphocyte subset quantitation

A. E. Brown, M. J. Dolan, N. L. Michael, S. Zhou, S. P. Perfetto, C. Hawkes, M. Robb, J. Lane, D. Mayers, J. G. McNeil, J. D. Malone, R. Garner, D. L. Birx

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Systems for the staging of individuals with human immunodeficiency virus type 1 (HIV-1) infection were developed 15 years ago. Subsequently, assays for quantitating HIV-1 RNA and immunophenotyping of lymphocyte subsets have been developed and validated. The utility of these assays for improved staging in early disease was evaluated in 256 HIV-infected adults (52% minority) with CD4 counts ≥ 400 cells/μL followed in U.S. military medical centers before the highly active anti-retroviral therapy era. HIV viral load (RNA) was quantitated; the frequencies of select CD4+ immunophenotypes were determined in 112 subjects. The results were analyzed in relation to three outcome measures: death, first acquired immunodeficiency syndrome-defining opportunistic infection, and CD4 count ≤ 200 cells/μL. Serum RNA level and CD4 count were each found to be predictive of all three outcomes. In addition, increases in the T-cell subsets CD28-CD4+ and CD29+CD26-CD4+ were found to be independently predictive of more rapid progression. The classification of early-stage HIV patients is improved by the quantitation of both viral RNA and T-lymphocyte subsets.

Original languageEnglish
Pages (from-to)571-576
Number of pages6
JournalMilitary Medicine
Volume166
Issue number7
DOIs
StatePublished - 2001

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