Quantitative HIV-1 RNA as a marker of clinical stability and survival in a cohort of 302 patients with a mean CD4 cell count of 300x10(6)/l
Quantitative HIV-1 RNA as a marker of clinical stability and survival in a cohort of 302 patients with a mean CD4 cell count of 300x10(6)/l
复制标题
DOI：
10.1097/00002030-199609000-00001
复制
发表时间：
1996-09-01
期刊：
影响因子：
3.8
通讯作者：
Foz, M
中科院分区：
文献类型：
--
作者：
Ruiz, L;Romeu, J;Foz, M
目的：为了分析血浆HIV-1 RNA水平作为一个标志的临床稳定性和生存在一个队列的HIV感染患者的血清转换的时间是unknown.Design：回顾性队列study.Setting：Retrovirology实验室和艾滋病单位在教学hospital.Patients：共916个样本，从302例，大多数抗逆转录病毒治疗，进行了分析。平均初始CD 4细胞计数和HIV-1 RNA分别为299 x 10（6）/l（范围：0-1600）和134 261拷贝/ml（范围：< 200-4 300 000）。66例既往诊断为艾滋病的患者。方法：根据初始和纵向病毒载量（VL）和CD 4细胞计数测量，采用Kaplan-Meier检验分析进展为艾滋病和生存的情况。相对风险计算考克斯的比例风险model.Results：在平均随访444 +/- 309天，29例患者发展为艾滋病和21死亡。与VL < 35 000组相关的进展的相对风险（RR）为：当CD 4大于或等于250 × 10（6）/l且VL大于或等于35 000时为10.4 CD 4 < 250 × 10（6）/l，VL ≥ 35000时为45.3（P < 0.0001）。对于所有连续VL测定值< 60 000的患者，第1、2和3年的累积进展概率分别为0%、0%和12.3%;对于VL值不总是< 60 000的患者，累积进展概率分别为13.3%、34.7%和79.3%（RR = 23; P < 0.0001）。结论：VL ≥ 35000是一个较好的预后判断指标，而CD 4细胞计数≥ 250 x106/l是一个较好的预后判断指标。连续VL测定< 60 000与更好的预后相关。
Objective: To analyse plasma HIV-1 RNA levels as a marker of clinical stability and survival in a cohort of HIV-infected patients whose time of seroconversion is unknown.Design: Retrospective cohort study.Setting: Retrovirology laboratory and AIDS Unit in a teaching hospital.Patients: A total of 916 samples from 302 patients, most on antiretroviral therapy, were analysed. Mean initial CD4 cell counts and HIV-1 RNA were 299 x 10(6)/l (range: 0-1600) and 134 261 copies/ml (range: < 200-4 300 000), respectively. Sixty-six cases had been diagnosed previously with AIDS.Methods: Analysis of progression to AIDS and survival, according to initial and longitudinal viral load (VL) and CD4 cell count measurements was performed by Kaplan-Meier test. Relative risks were calculated by Cox's proportional hazards model.Results: During a mean follow-up of 444 +/- 309 days, 29 patients developed AIDS and 21 died. Relative risk (RR) of progression related to the group with VL < 35 000 was: 10.4 when CD4 greater than or equal to 250 x 10(6)/l and VL greater than or equal to 35 000 (P = 0.001); and 45.3 when CD4 < 250 x 10(6)/l and VL greater than or equal to 35 000 (P < 0.0001). Cumulative probability of progression was: 0%, 0% and 12.3%, at the first, second and third year respectively, for patients with all their sequential VL determinations < 60 000; acid 13.3%, 34.7% and 79.3% for patients who did not maintain VL values always < 60 000 (RR = 23; P < 0.0001). The minimum value of VL that reached statistical significance for the survival analysis was 100 000 copies/ml (P < 0.0001).Conclusions: VL greater than or equal to or < 35 000 is a better discriminant for progression than a CD4 cell count greater than or equal to or < 250 x 10(6)/l. Sequential VL determinations < 60 000 are associated with a better prognosis.