Longitudinal serum HIV RNA quantification: Correlation to viral phenotype at seroconversion and clinical outcome
Longitudinal serum HIV RNA quantification: Correlation to viral phenotype at seroconversion and clinical outcome
复制标题
DOI：
10.1097/00002030-199602000-00006
复制
发表时间：
1996-02-01
期刊：
影响因子：
3.8
通讯作者：
Gerstoft, J
中科院分区：
文献类型：
--
作者：
Katzenstein, TL;Pedersen, C;Gerstoft, J
目的：研究血清HIV RNA的纵向变化，阐明感染早期病毒载量对临床结果是否具有预测价值；此外，将血清转化时的病毒表型以及 CD4 细胞计数的变化与病毒负荷相关联。 设计：20 名血清转化者在血清转化时获得 HIV 分离株，在血清转化时通过聚合酶链式反应 (PCR) 进行 HIV RNA 定量，此后每 6 个月进行一次。平均随访时间为 65 个月。根据血清转换时的病毒表型、艾滋病进展时间、第一年内的血清病毒载量（低于或高于 1.5 x 10(4) 拷贝/ml）对患者进行分类。结果：血清转换时的高病毒载量随后在最初几个月内显着下降（P < 0.0005）。下降到 < 1.5 x 10(4) 拷贝/ml 与艾滋病进展缓慢相关（P < 0.05）。还显示了 CD4 下降率与随后的病毒载量平台期中位病毒载量之间的相关性 (P < 0.05)。此阶段之后，病毒负荷增加。快速进展者比慢速或非进展者具有更高的病毒载量；这在感染后期尤其明显。与非 SI 相比，血清转化时携带合胞体诱导 (SI) 病毒与艾滋病进展速度更快相关 (NSI；P < 0.005)。 SI 相对于 NSI 的体外复制率增加并未转化为显着较高的血清 HIV RNA。结论：血清转换时血清 HIV RNA 较高。此后头几个月内显着下降，随后进入平台期，随后 HIV RNA 增加。感染早期的 HIV RNA 对临床结果具有预测价值。 SI 相对 NSI 病毒的毒力增加并没有转化为显着更高的 HIV RNA 值。
Objective: To investigate the longitudinal changes in serum HIV RNA, and to clarify whether the viral load early in infection has a predictive value for the clinical outcome; also, to correlate viral phenotype at seroconversion and changes in CD4 cell counts with viral burden.Design: Twenty seroconverters with HIV isolates available at seroconversion had HIV RNA quantified by polymerase chain reaction (PCR) at seroconversion and thereafter every 6 months. Mean follow-up time was 65 months. Patients were classified according to viral phenotype at seroconversion, time to AIDS progression, serum viral load within the first year (less or more than 1.5 x 10(4) copies/ml).Results: High viral load at seroconversion was followed by a significant decline within the first months (P < 0.0005). Decline to < 1.5 x 10(4) copies/ml was correlated with slower progression to AIDS (P < 0.05). A correlation between the rate of CD4 decline and the median viral load during the ensuing viral load plateau phase was also shown (P < 0.05). Subsequent to this phase the viral burden increased. Rapid progressors had higher viral load than slow- or non-progressors; this was particularly pronounced late in infection. Harbouring syncytium-inducing (SI) virus at seroconversion was associated with faster progression to AIDS than non-SI (NSI; P < 0.005). The increased in vitro replication rate of SI over NSI was not translated into significantly higher serum HIV RNA.Conclusion: Serum HIV RNA is high around the time of seroconversion. A significant decline within the first months hereafter is followed by a plateau phase, which in turn is followed by an increase in HIV RNA. HIV RNA early in infection has a predictive value for the clinical outcome. The increased virulence of SI over NSI virus did not translate into significantly higher HIV RNA values.