Τίτλος:
Serum HIV-1 RNA levels and time to development of AIDS in the
multicenter hemophilia cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective.-To determine if the long-term incidence of the acquired
immunodeficiency syndrome (AIDS) is related to human immunodeficiency
virus type 1 (HIV-1) RNA levels measured early in HIV-1 infection.
Design.-Epidemiologic cohort study.
Setting.-Five hemophilia treatment centers in the United States.
Subjects.-A total of 165 subjects with hemophilia and HIV-1 infection
(age at HIV-1 seroconversion, 1-66 years) followed from 1979 to 1995.
Methods.-The HIV-1 RNA level was measured by polymerase chain reaction
over a range of 200 to 1 million or more HIV-1 RNA copies/mL. in
archived serum specimens collected 12 to 36 months (median, 27 months)
after the estimated date of HIV-1 seroconversion. Kaplan-Meier methods
were used to examine the risk of AIDS and proportional hazards models
were used to estimate relative hazards.
Results.-The HIV-1 RNA values were similar in subjects younger than 17
years at seroconversion (median, 5214 copies/mL) and those 18 to 34
years old (median, 4693 copies/mL), but higher in those 35 years or
older (median, 12 069 copies/mL) (P=.02 compared with each younger
group). At 10 years after seroconversion, the proportions of subjects
with AIDS were 72% among subjects with 100 000 or more HIV-1 RNA
copies/mL measured 12 to 36 months after HIV-1 seroconversion (n=9),
52% among subjects with 10 000 to 99 999 copies/mL (n=55), 22% among
subjects with 1000 to 9999 copies/mL (n=82), and 0% among subjects with
fewer than 1000 copies/mL (n=19) (P<.001). The age-adjusted relative
hazard for AIDS for subjects with 10 000 or more copies/mL was 14.3
(95% confidence interval, 1.9-105.6) compared with subjects with fewer
than 1000 copies/mL.
Conclusions.-The HIV-1 RNA level during early chronic HIV-1 infection is
a strong, age-independent predictor of clinical outcome; low revels
define persons with a high probability of long-term AIDS-free survival.
Συγγραφείς:
OBrien, TR
Blattner, WA
Waters, D
Eyster, ME
Hilgartner,
MW
Cohen, AR
Luban, N
Hatzakis, A
Aledort, LM and
Rosenberg, PS
Miley, WJ
Kroner, BL
Goedert, JJ
Περιοδικό:
JAMA - JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION - INTERNATIONAL EDITION
Εκδότης:
AMER MEDICAL ASSOC
DOI:
10.1001/jama.276.2.105
