4.6 Article

A Novel Acute Retroviral Syndrome Severity Score Predicts the Key Surrogate Markers for HIV-1 Disease Progression

期刊

PLOS ONE
卷 9, 期 12, 页码 -

出版社

PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0114111

关键词

-

资金

  1. Swiss National Science Foundation [324730-130865, PZ00P3-142411]
  2. University of Zurich's Clinical Research Priority Program (CRPP) Viral infectious diseases: Zurich Primary HIV Infection Study''
  3. University Hospital of Zurich
  4. Swiss National Science Foundation (SNF) [PZ00P3_142411, 324730_130865] Funding Source: Swiss National Science Foundation (SNF)

向作者/读者索取更多资源

Objective: Best long-term practice in primary HIV-1 infection (PHI) remains unknown for the individual. A risk-based scoring system associated with surrogate markers of HIV-1 disease progression could be helpful to stratify patients with PHI at highest risk for HIV-1 disease progression. Methods: We prospectively enrolled 290 individuals with well-documented PHI in the Zurich Primary HIV-1 Infection Study, an open-label, non-randomized, observational, single-center study. Patients could choose to undergo early antiretroviral treatment (eART) and stop it after one year of undetectable viremia, to go on with treatment indefinitely, or to defer treatment. For each patient we calculated an a priori defined Acute Retroviral Syndrome Severity Score'' (ARSSS), consisting of clinical and basic laboratory variables, ranging from zero to ten points. We used linear regression models to assess the association between ARSSS and log baseline viral load (VL), baseline CD4(+) cell count, and log viral setpoint (sVL) (i.e. VL measured >= 90 days after infection or treatment interruption). Results: Mean ARSSS was 2.89. CD4(+) cell count at baseline was negatively correlated with ARSSS (p=0.03, n=289), whereas HIV-RNA levels at baseline showed a strong positive correlation with ARSSS (p<0.001, n=290). In the regression models, a 1-point increase in the score corresponded to a 0.10 log increase in baseline VL and a CD4(+) cell count decline of 12/mu l, respectively. In patients with PHI and not undergoing eART, higher ARSSS were significantly associated with higher sVL (p=0.029, n=64). In contrast, in patients undergoing eART with subsequent structured treatment interruption, no correlation was found between sVL and ARSSS (p=0.28, n=40). Conclusion: The ARSSS is a simple clinical score that correlates with the best-validated surrogate markers of HIV-1 disease progression. In regions where ART is not universally available and eART is not standard this score may help identifying patients who will profit the most from early antiretroviral therapy.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据