AEGiS-05CROI: Longitudinal plasma HIV RNA patterns among HIV-1 infected individuals with late disease progression.

5th Conference on Retroviruses and Opportunistic Infections


Chicago, IL - February 1-5, 1998



Longitudinal plasma HIV RNA patterns among HIV-1 infected individuals with late disease progression.

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:81 (abstract no. 12)

Gange SJ, Mellors JW, Schrager L, Margolick JB, Giorgi JV, Detels R, Phair J, Munoz A; Johns Hopkins School of Public Health, Baltimore, MD.

OBJECTIVE: We compared longitudinal changes in plasma HIV RNA (Roche HIV Monitor) among individuals selected for stable CD4+ counts and no disease progression for seven years but who showed differences in disease progression over the subsequent five years.

METHODS: 62 homosexual men who were HIV+ at enrollment in the MACS had no decline in CD4+ count and no use of antiretroviral therapy from 4/84 to 3/91. Data collected between 3/91 and 9/96 were used to classify these men into three groups: Those developing clinical AIDS (n=20) and those remaining AIDS-free (n=42) divided into two groups of faster (n=21) and slower (n=21) progressors based on whether their overall CD4+ slope was less than or greater than the median change for the group (-13 cells/year). Random effects models were used to describe the trajectories of log10 HIV RNA before and after 3/91.

RESULTS: Both the group developing AIDS and the group showing faster CD4+ decline after 3/91 had increasing HIV RNA between 4/85 and 3/91 at a rate of 20% and 17% per year, respectively. HIV RNA increased more rapidly (61%/year) among the AIDS group after 3/91. The group showing slow CD4+ decline after 3/91 had decreasing HIV RNA between 4/85 and 3/91 (slope of -7.0%/year) that was significantly different (p less than .001) from the other two groups. The mean HIV RNA level of the slow CD4+ decline group was significantly different (p less than 0.05) from the mean level of the AIDS group beginning in 1989, three years before differences in disease progression were observed.

CONCLUSIONS: In untreated HIV-infected individuals, stability of CD4+ cell counts and nonprogression to AIDS was associated with stable or declining HIV RNA levels. Late progressors showed increases in HIV RNA years before the onset of symptoms and a steeper change was observed close to the onset of AIDS.

Keywords: AEGIS, HIV-1, HIV, Disease Progression, CD4 Lymphocyte Count, Acquired Immunodeficiency Syndrome, HIV Infections, RNA, Viral, Antigens, CD4, Anti-HIV Agents, RNA, HIV Seropositivity, HIV Core Protein p24, Reverse Transcriptase Inhibitors, HIV Seronegativity, Human, Male, immunology, AIDS

1998-02-01
12

Copyright © 1998 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.