The associations of CD4 cell count, plasma human immunodeficiency virus (HIV) type 1 RNA, infectious HIV titer in peripheral blood mononuclear cells, immune complex-disrupted (ICD) p24 antigen, and MT-2 assays with measures of disease progression after drug treatment were assessed in a subset of patients enrolled in AIDS Clinical Trials Group Study 175. Baseline plasma RNA levels and changes in RNA values at weeks 8 or 56 were more important predictors of disease progression than were baseline or changes in CD4 cell counts. Each 10-fold lower HIV RNA concentration at baseline and each 10- fold decrease in HIV RNA between baseline and week 8 was associated with increases of 49-61 CD4 cells/mm3 at weeks 56 and 104. In multivariate analyses, neither baseline values nor changes in infectious HIV titer nor ICD p24 antigen concentrations were associated with long-term changes in CD4 cell count. Plasma HIV-1 RNA appears to be the best predictor of long-term CD4 cell count responses and disease progression.
Bibliographical noteFunding Information:
Received 20 May 1997; revised 22 September 1997. Presented in part: 4th Conference on Retroviruses and Opportunistic Infections, Washington, DC, 22–26 January 1997 (abstract 544). Informed consent was obtained from all study participants. This study followed the human experimentation guidelines of the US Department of Health and Human Services. Grant support: NIH (AI-27670, AI-38858, and AI-36214 to J.L.L.; AI-25868, 96-VC-006, and RR-00046 to S.A.F.; AI-65304 to J.B.J.; AI-27658 and RR-0004 to R.R.; AI-27659 and AI-29193 to R.B.; and AI-27560 to W.S.). Reprints or correspondence: Dr. Susan A. Fiscus, Dept. of Microbiology & Immunology, CB 7140, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7140 (firstname.lastname@example.org). * Present affiliation: Abbott Laboratories, Abbott Park, Illinois. † Another ACTG 175 virology team member was Richard D’Aquila, Massachusetts General Hospital and Harvard Medical School.