Copy-Years Viremia as a Measure of Cumulative Human Immunodeficiency Virus Viral Burden
Copy-Years Viremia as a Measure of Cumulative Human Immunodeficiency Virus Viral Burden
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DOI：
10.1093/aje/kwp347
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发表时间：
2010-01-15
影响因子：
5
通讯作者：
Saag, Michael S.
中科院分区：
文献类型：
--
作者：
Cole, Stephen R.;Napravnik, Sonia;Saag, Michael S.
血浆人类免疫缺陷病毒1型（HIV-1）病毒载量是HIV研究和临床护理的一个有价值的工具，但通常以非累积方式使用。作者在多中心艾滋病队列研究（1984-1996）的297名HIV感染者中发展了复制年病毒血症，作为累积血浆HIV-1病毒载量暴露的测量指标。男性从血清转化到发生获得性免疫缺陷综合征（艾滋病）、死亡或开始联合抗逆转录病毒治疗（1996年1月1日）；中位随访时间为4.6年（四分位数间距（IQR）， 2.7-6.5）。在2,281次半年随访评估中，中位病毒载量和拷贝年病毒血症水平分别为29,628拷贝/mL （IQR, 8,547-80,210）和63,659拷贝/mL （IQR, 15,935-180,341）。共有127名男性患艾滋病或死亡，170名没有感染艾滋病，但在1996年1月1日被审查或随访失败。复制年病毒血症与其他病毒载量指标之间的等级相关性为0.56-0.87。复制年病毒血症每增加log(10)，与艾滋病或死亡风险增加1.70倍（95%可信区间：0.94,3.07）相关，与感染持续时间、年龄、种族、CD4细胞计数、设定点、峰值病毒载量或最近的病毒载量无关。复制年病毒血症是一种新的累积病毒负荷测量方法，它可以提供超越传统单一病毒血症测量方法的预后信息。
Plasma human immunodeficiency virus type 1 (HIV-1) viral load is a valuable tool for HIV research and clinical care but is often used in a noncumulative manner. The authors developed copy-years viremia as a measure of cumulative plasma HIV-1 viral load exposure among 297 HIV seroconverters from the Multicenter AIDS Cohort Study (1984-1996). Men were followed from seroconversion to incident acquired immunodeficiency syndrome (AIDS), death, or the beginning of the combination antiretroviral therapy era (January 1, 1996); the median duration of follow-up was 4.6 years (interquartile range (IQR), 2.7-6.5). The median viral load and level of copy-years viremia over 2,281 semiannual follow-up assessments were 29,628 copies/mL (IQR, 8,547-80,210) and 63,659 copies x years/mL (IQR, 15,935-180,341). A total of 127 men developed AIDS or died, and 170 survived AIDS-free and were censored on January 1, 1996, or lost to follow-up. Rank correlations between copy-years viremia and other measures of viral load were 0.56-0.87. Each log(10) increase in copy-years viremia was associated with a 1.70-fold increased hazard (95% confidence interval: 0.94, 3.07) of AIDS or death, independently of infection duration, age, race, CD4 cell count, set-point, peak viral load, or most recent viral load. Copy-years viremia, a novel measure of cumulative viral burden, may provide prognostic information beyond traditional single measures of viremia.