Serum HIV-1 RNA levels and time to development of AIDS in the Multicenter Hemophilia Cohort Study - PubMed (original) (raw)
Multicenter Study
. 1996 Jul 10;276(2):105-10.
W A Blattner, D Waters, E Eyster, M W Hilgartner, A R Cohen, N Luban, A Hatzakis, L M Aledort, P S Rosenberg, W J Miley, B L Kroner, J J Goedert
Affiliations
- PMID: 8656501
Multicenter Study
Serum HIV-1 RNA levels and time to development of AIDS in the Multicenter Hemophilia Cohort Study
T R O'Brien et al. JAMA. 1996.
Abstract
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, 12069 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 9,999 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 levels define persons with a high probability of long-term AIDS-free survival.
Comment in
- Dose of non-heat-treated factor VIII concentrate and HIV-1 RNA levels.
Montoro JB, Oliveras J, Altisent C, Ruiz I. Montoro JB, et al. JAMA. 1997 Jan 1;277(1):20-1. JAMA. 1997. PMID: 8980200 No abstract available.
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