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Titolo:
QUANTIFICATION OF HIV-1 VIRUS LOAD UNDER ZIDOVUDINE THERAPY IN PATIENTS WITH SYMPTOMATIC HIV-INFECTION - RELATION TO DISEASE PROGRESSION
Autore:
MOLINA JM; FERCHAL F; CHEVRET S; BARATEAU V; POIROT C; MORINET F; MODAI J;
Indirizzi:
HOP ST LOUIS,DEPT INFECT DIS,1 AVE C VELLEFAUX F-75010 PARIS FRANCE HOP ST LOUIS,MICROBIOL LAB PARIS FRANCE HOP ST LOUIS,DEPT BIOSTAT PARIS FRANCE
Titolo Testata:
AIDS
fascicolo: 1, volume: 8, anno: 1994,
pagine: 27 - 33
SICI:
0269-9370(1994)8:1<27:QOHVLU>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; TYPE-1 INFECTION; PROGNOSTIC VALUE; P24 ANTIGEN; VIREMIA; INDIVIDUALS; PLASMA; AIDS;
Keywords:
HIV; PLASMA VIREMIA; CELLULAR VIREMIA; CD4; CD8; P24 ANTIGEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
J.M. Molina et al., "QUANTIFICATION OF HIV-1 VIRUS LOAD UNDER ZIDOVUDINE THERAPY IN PATIENTS WITH SYMPTOMATIC HIV-INFECTION - RELATION TO DISEASE PROGRESSION", AIDS, 8(1), 1994, pp. 27-33

Abstract

Objective: To measure changes in HIV-1 virus load following zidovudine therapy, and to investigate the relationship between these changes and clinical progression. Design: Prospective study of 18 symptomatic, zidovudine-naive patients, with CD4 count <350x10(6)/l. Methods: The following parameters were measured at each visit, before zidovudine therapy, after 1 month of therapy, and every 3 months thereafter. HIV-1 virus load in peripheral blood was determined by serum immune complex-dissociated HIV-1 p24 antigen (ICD-p24 Ag), quantitative plasma and cellular viraemia. A virologic response under zidovudine was defined as >50% decrease in ICD-p24 Ag levels or > 1 log(10) decrease in plasma or cellular viraemia titres from baseline values. CD4 and CD8 cell counts, and beta(2)-microglobulin levels were also measured. Disease progression was defined as the time to a new AIDS-defining event or death. Results: At enrolment, 13 out of 18 (72%) patients had positive ICD-p24 Ag and positive plasma viraemia, with a mean of 44 median tissue culture infective dose (TCID50) per ml; all patients had positive cellular viraemia with a mean TCID50 of 230 per 10(6)/l cells. Median CD4 cell count was 43 x10(6)/l. Ten patients developed a new AIDS-defining event and eight died during a median follow-up of 15 months on zidovudine. Baseline prognostic markers for development of a new AIDS-defining event included ICD-p24 Ag, CD4 and CD8 cell counts, but only CD4 cell count remained predictive on multivariate analysis (P = 0.003). When each laboratory marker was analysed as a time-dependent covariate, onlyCD4 (P = 0.002) and CD8 (P = 0.001) cell counts predicted the occurrence of a new AIDS-defining event. Eight out of 13 (61.5%) patients hadan ICD-p24 Ag response, and seven out of 13 (54%) a plasma viraemia response, but only cellular viraemia responders (five out of 18; 28%) had a 5.6-fold decrease in their risk of developing an AIDS-defining event (90% confidence interval, 1-33; P = 0.05). None of these markers correlated with survival. Conclusions: Plasma viraemia and ICD-p24 Ag, while providing useful short-term markers of zidovudine antiviral activity in vivo, do not correlate with disease progression in patients with advanced HIV infection. CD4 cell count remained the best initial and time-dependent predictor for development of new AIDS-defining events. Interestingly, a high CD8 cell count and a decrease in cellular viraemia titres also appear to be predictive of improved clinical outcome in this population.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/09/20 alle ore 19:14:11