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Use of changes in plasma levels of human immunodeficiency virus type 1 RNA to assess the clinical benefit of antiretroviral therapy.

Authors
  • Marschner, I C
  • Collier, A C
  • Coombs, R W
  • D'Aquila, R T
  • DeGruttola, V
  • Fischl, M A
  • Hammer, S M
  • Hughes, M D
  • Johnson, V A
  • Katzenstein, D A
  • Richman, D D
  • Smeaton, L M
  • Spector, S A
  • Saag, M S
Type
Published Article
Journal
The Journal of infectious diseases
Publication Date
Jan 01, 1998
Volume
177
Issue
1
Pages
40–47
Identifiers
PMID: 9419168
Source
Medline
License
Unknown

Abstract

Data from 1330 human immunodeficiency virus type 1 (HIV-1)-infected patients enrolled in seven antiretroviral treatment trials were analyzed to characterize the clinical benefit of treatment-mediated reductions in plasma HIV-1 RNA levels. The risk of a new AIDS-defining event or death was reduced proportionally to the magnitude of the reduction of the HIV-1 RNA level during the first 6 months of therapy. Pretherapy HIV-1 RNA levels were prognostic independently of on-therapy levels. In addition, the reduction in risk associated with any given reduction of the level of HIV-1 RNA did not vary by pretherapy level. Having either a reduction in HIV-1 RNA level or an increase in CD4+ lymphocyte count, or both, was associated with a delay in clinical disease progression. This indicates that patient prognosis should be assessed using both HIV-1 RNA and CD4+ lymphocyte responses to therapy.

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