Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 181, Issue 3, Pages 872-880Publisher
UNIV CHICAGO PRESS
DOI: 10.1086/315339
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Funding
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [U01AI037984, U01AI035043, U01AI035042] Funding Source: NIH RePORTER
- NIAID NIH HHS [AI-35043, AI-35042, AI-37984] Funding Source: Medline
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The natural history of human immunodeficiency virus type 1 (HIV-1) viremia and its association with clinical outcomes after seroconversion was characterized in a cohort of homosexual men. HIV-1 RNA was measured by reverse-transcription polymerase chain reaction (RT-PCR) in stored longitudinal plasma samples from 269 seroconverters. Subjects were generally antiretroviral drug naive for the first 3 years after seroconversion. The decline in CD4 lymphocyte counts was strongly associated with initial HIV RNA measurements. Both initial HIV RNA levels and slopes were associated with AIDS-free times. Median slopes were +0.18, +0.09, and -0.01 log(10) copies/mL, respectively, for subjects developing AIDS <3, 3-7, and >7 years after seroconversion. In contrast, HIV RNA slopes in the 3 years preceding AIDS and HIV RNA levels at AIDS diagnosis showed little variation according to total AIDS-free time. HIV RNA load at the first HN-seropositive visit (similar to 3 months after seroconversion) was highly predictive of AIDS, and subsequent HIV RNA measurements showed even better prognostic discrimination.
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