Third International Congress Drug Therapy in HIV Infection 3-7 November 1996 Glasgow, UK

CD4 COUNTS RETAIN THEIR PROGNOSTIC VALUE OVER PLASMA VIRAL LOAD IN INDIVIDUALS ON COMBINATION THERAPY WITH CD4 COUNTS 50 TO 350 MM³

Montaner JSG, Raboud JM, Rae S, Conway B, Patenaude P, O'Shaughnessy MV, Schechter MT, et al.
BC Centre for Excellence in HIV/AIDS and the Canadian HIV Trials Network, Vancouver, Canada.

Int Cong Drug Therapy HIV 1996 Nov 3-7;3:Abstract No. OP1.3
AIDS 1996, Vol. 10 (Suppl. 2);S9

The objective of this study is to compare the ability of CD4 counts and plasma viremia to predict progression to a new ADI or death in a randomized trial of ZDV + ddI vs. ZDV + ddC in patients with CD4 counts between 50 and 350.

123 patients were enrolled; 60 on ddI, 63 on ddC. 62 patients had ≤ 3 months of prior ZDV at enrollment. CD4 counts and plasma viremia were measured by Roche's Amplicor HIV-1 Monitor test at baseline, 2 weeks of follow-up and at months 1, 2, 3, 5 and 7. Median follow-up was 32 months.

The mean CD4 count and log₁₀ plasma viremia at enrollment were 231 cells/mm³ and 3.67 copies/ml. There were no significant differences in CD4 counts, plasma viremia or clinical endpoints between treatment groups. In a multivariate Cox model controlling for the effect of treatment, the RR's of progressing to a new ADI or death associated with baseline CD4 count and plasma viremia were 0.46 (p=.002) and 1.24 (p=.47). Similarly, the RR's associated with CD4 counts and plasma viremia using time-dependent covariates were 0.52 (p=.01) and 1.44 (p=.13). Changes in CD4 and viral load from 0-8 weeks as measured by normalized area under the curve or area under the curve minus baseline were not predictive of progression to new ADI or death.

In summary, in individuals with CD4's from 50 to 350 who receive 2 nucleoside analogs, both CD4 counts and plasma viremia are predictive in univariate models. However, CD4 counts are more predictive of progression of disease than plasma viremia in a multivariate model. Absolute values of CD4 counts and plasma viremia are predictive while changes from baseline were not.

Presenting author: Montaner JSG

1996-11-03
OP1.3

Originally published in AIDS Volume 10, Supplement 2 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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