Estimation of the predictive role of plasma viral load on CD4 decline in HIV-1 subtype C-infected subjects in India

Ming Ding, Patrick Tarwater, Milka Rodriguez, Ramdas Chatterjee, Deena Ratner, Yasuhiro Yamamura, Pratima Roy, John Mellors, Dhruba Neogi, Yue Chen, Phalguni Gupta

Research output: Contribution to journalArticle

Abstract

Background: Plasma viral load has been shown to be a meaningful prognostic marker for disease progression in untreated, HIV-1 subtype B-infected subjects in United States and Western Europe and therefore used as a prognostic marker for disease progression. Because of high expenses of commercially available viral load assays, the role of viral load in disease progression has not been evaluated in HIV-1 subtype C-infected patients in India. Methods: We developed an inexpensive real-time reverse transcriptase-polymerase chain reaction assay to quantify viral load in plasma of HIV-1 subtype C-infected subjects from India and used it in a longitudinal analysis of viral load and CD4 cell number in HIV-infected subjects from Calcutta, India. Results: The real-time reverse transcriptase-polymerase chain reaction assay can quantify plasma viral load with a linear range of detection from 102 to 109 HIV-1 RNA copies per input. Longitudinal analysis of viral load in a cohort of 39 subjects over an average period of approximately 3 years indicates that 1-log increase in HIV-1 RNA level was associated with a decline of 67 CD4 cell count. Furthermore, HIV-1 RNA level between 500 and 50,000 copies per milliliter would predict a 12.9% decrease in CD4 cell count per year, whereas HIV-1 RNA levels above 50,000 copies HIV-1 RNA per milliliter would predict a 25.3% decrease in CD4 cells per year. In addition, we estimated that the mean incubation period of disease development, as defined by the loss of CD4 below 200, is 8.2 years. Conclusion: Our report on the level of viral load on predicting CD4 decline in Indian subjects with HIV-1 provides an additional important tool to the physicians for treating and planning a therapeutic strategy to control HIV-1 infection in India.

Original languageEnglish (US)
Pages (from-to)119-125
Number of pages7
JournalJournal of acquired immune deficiency syndromes
Volume50
Issue number2
DOIs
StatePublished - Feb 1 2009

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Keywords

  • CD4 decline
  • Indian subjects
  • Plasma HIV load
  • Real-time RT-PCR

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Ding, M., Tarwater, P., Rodriguez, M., Chatterjee, R., Ratner, D., Yamamura, Y., Roy, P., Mellors, J., Neogi, D., Chen, Y., & Gupta, P. (2009). Estimation of the predictive role of plasma viral load on CD4 decline in HIV-1 subtype C-infected subjects in India. Journal of acquired immune deficiency syndromes, 50(2), 119-125. https://doi.org/10.1097/QAI.0b013e3181911991