Predictive value of immunologic and virologic markers after long or short duration of HIV-1 infection

Janis V. Giorgi, Robert H. Lyles, Jose L. Matud, Traci E. Yamashita, John W. Mellors, Lance E. Hultin, Beth D. Jamieson, Joseph B. Margolick, Charles R. Rinaldo, John P. Phair, Roger Detels

Research output: Contribution to journalArticle

Abstract

Laboratory markers that predict HIV-1 disease progression include plasma viral burden, CD4+ T-cell count, and CD38 expression on CD8 T cells. To better understand whether the predictive value of these markers is dependent on how long an individual has been infected, we analyzed data from the Multicenter AIDS Cohort Study early (median = 2.8 years) and late (median = 8.7 years) in the course of infection. Overall, we found that HIV RNA and CD38 levels were similarly predictive of AIDS early on compared with a relatively weaker CD4 cell count signal. Later in the course of infection, CD38 level remained the strongest predictive marker and CD4 cell count registered a marked increase in prognostic power. Among untreated individuals, there was little difference in prognosis (median time to AIDS) associated with given marker values regardless of infection duration. The prognosis given a specific viral load level tended to deteriorate late in the course of infection among those undergoing treatment with monotherapy or combination therapy, however. These data provide a unique historical look at the predictive value and prognostic significance of HIV-1 disease markers at different stages of infection in a large cohort, with direct relevance to current patients who are untreated or for whom treatment is ineffective.

Original languageEnglish (US)
Pages (from-to)346-355
Number of pages10
JournalJournal of acquired immune deficiency syndromes
Volume29
Issue number4
DOIs
StatePublished - Apr 1 2002

Keywords

  • AIDS
  • CD38
  • CD4 cell counts
  • Disease stage
  • HIV RNA load
  • Prognosis

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Giorgi, J. V., Lyles, R. H., Matud, J. L., Yamashita, T. E., Mellors, J. W., Hultin, L. E., Jamieson, B. D., Margolick, J. B., Rinaldo, C. R., Phair, J. P., & Detels, R. (2002). Predictive value of immunologic and virologic markers after long or short duration of HIV-1 infection. Journal of acquired immune deficiency syndromes, 29(4), 346-355. https://doi.org/10.1097/00126334-200204010-00004