The relation of virologic and immunologic markers to clinical outcomes after nucleoside therapy in HIV-infected adults with 200 to 500 CD4 cells per cubic millimeter. AIDS Clinical Trials Group Study 175 Virology Study Team.
The relation of virologic and immunologic markers to clinical outcomes after nucleoside therapy in HIV-infected adults with 200 to 500 CD4 cells per cubic millimeter. AIDS Clinical Trials Group Study 175 Virology Study Team.
复制标题
每立方毫米 200 至 500 个 CD4 细胞的 HIV 感染成人接受核苷治疗后，病毒学和免疫学标记物与临床结果的关系。
DOI：
--
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发表时间：
1996
影响因子：
158.5
通讯作者：
M. Hirsch
中科院分区：
文献类型：
--
作者：
D. Katzenstein;S. Hammer;M. Hughes;H. Gundacker;J. Jackson;S. Fiscus;S. Rasheed;T. Elbeik;R. Reichman;A. Japour;T. Merigan;M. Hirsch
BACKGROUND
We studied measures of human immunodeficiency virus (HIV) replication, the viral phenotype, and immune function (CD4 cell counts) and the relation of changes in these indicators to clinical outcomes in a subgroup of patients in a controlled trial of early antiretroviral treatment for HIV, the AIDS Clinical Trials Group Study 175.
METHODS
The 391 subjects, each of whom entered the study with a single screening CD4 cell count of 200 to 500 per cubic millimeter, were randomly assigned to receive zidovudine alone, didanosine alone, zidovudine plus didanosine, or zidovudine plus zalcitabine. Plasma concentrations of HIV RNA were assessed in 366 subjects, and viral isolates from 332 subjects were assayed for the presence of the syncytium-inducing phenotype.
RESULTS
After eight weeks, the mean (+/-SE) decrease from base line in the concentration of HIV RNA, expressed as the change in the base 10 log of the number of copies per milliliter, was 0.26+/-0.06 for patients treated with zidovudine alone, 0.65+/-0.07 for didanosine alone, 0.93+/-0.10 for zidovudine plus didanosine, and 0.89+/-0.06 for zidovudine plus zalcitabine (P<0.001 for each of the pairwise comparisons with zidovudine alone). Multivariate proportional-hazards models showed that higher base-line concentrations of plasma HIV RNA, less suppression of plasma HIV RNA by treatment, and the presence of the syncytium-inducing phenotype were significantly associated with an increased risk of progression to the acquired immunodeficiency syndrome and death. After adjustment for these measures of viral replication and for the viral phenotype, CD4 cell counts were not significant predictors of clinical outcome.
CONCLUSIONS
Both the risk of the progression of HIV disease and the efficacy of antiretroviral therapy are strongly associated with the plasma level of HIV RNA and with the viral phenotype. The changes in the plasma concentration of HIV RNA predict the changes in CD4 cell counts and survival after treatment with reverse-transcriptase inhibitors.
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DOI：
10.1172/jci115494
发表时间：
1991
期刊：
The Journal of clinical investigation
影响因子：
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作者：
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影响因子：
158.5
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10.1001/jama.1995.03530070052029
发表时间：
1995-08
期刊：
JAMA
影响因子：
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D. Henrard;J. Phillips;L. Muenz;W. Blattner;D. Wiesner;M. Eyster;J. Goedert
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DOI：
10.1093/infdis/170.3.553
发表时间：
1994
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Lin,HJ;Myers,LE;Yen-Lieberman,B;Hollinger,FB;Henrard,D;Hooper,CJ;Kokka,R;Kwok,S;Rasheed,S;Vahey,M
通讯作者：
Vahey,M
齐多夫定治疗患者的 HIV-1 合胞体诱导表型、病毒负荷、密码子 215 逆转录酶突变和 CD4 细胞下降。
DOI：
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发表时间：
1994
期刊：
Journal of acquired immune deficiency syndromes
影响因子：
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作者：
Kozal,MJ;Shafer,RW;Winters,MA;Katzenstein,DA;Aguiniga,E;Halpern,J;Merigan,TC
通讯作者：
Merigan,TC