HIV-1 RNA, CD4 cell count and the risk of progression to AIDS and death during treatment with HIV-1 reverse transcriptase inhibitors
HIV-1 RNA, CD4 cell count and the risk of progression to AIDS and death during treatment with HIV-1 reverse transcriptase inhibitors
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DOI：
10.1097/00002030-199815000-00010
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发表时间：
1998-10-22
期刊：
影响因子：
3.8
通讯作者：
Dawson, D
中科院分区：
文献类型：
--
作者：
Staszewski, S;DeMasi, R;Dawson, D
背景：关于HIV-1RNA水平和CD4细胞计数与在使用逆转录酶抑制剂治疗期间进展为艾滋病或死亡的风险之间的相关性的信息很少。目的：确定HIV-1RNA水平和CD4细胞计数与进展为艾滋病或死亡的1年风险之间的相关性。设计：关于齐多夫定/拉米夫定与对照治疗的6项随机临床试验的汇集分析。地点：欧洲、北美、澳大利亚和南非的研究地点。患者：这些试验招募了1488名年龄大于或等于18岁的成年HIV-1感染男性和女性患者，主要观察指标：进展(定义为所有新的和复发的艾滋病定义事件或死亡)与治疗前8至52周内的HIV-1RNA水平和CD_4细胞计数相关。结果：在中位7年的随访期内，进展主要限于CD_4细胞计数低(小于或等于200×10(6)细胞/L)和高HIV-1RNA水平(>；5000拷贝/毫升)。随着HIV-1RNA水平的升高和CD_4细胞数低于200×10~6个/ml/L，进展事件的发生率增加。HIV-1RNA小于或等于5000拷贝/ml的事件一般不典型。结论：HIV-1RNA小于或等于5000拷贝/ml的患者很少发展为艾滋病或死亡，尤其是当CD_4细胞数大于200×10(6)细胞/L时。
Context: There is little information available on the correlation between HIV-1 RNA level, CD4 cell count and the risk of progression to AIDS or death during treatment with reverse transcriptase inhibitors.Objectives: To define the correlation between HIV-1 RNA level, CD4 cell count and the 1 year risk of progression to AIDS or death.Design: Pooled analysis of six randomized clinical trials of zidovudine/lamivudine versus control treatments.Setting: Investigational sites in Europe, North America, Australia and South Africa.Patients: The trials recruited 1488 adult HIV-1-infected male and female patients aged greater than or equal to 18 years, with inclusion CD4 cell count between 25 and 500 x 100 cells/l.Patients were either nucleoside analogue-naive or pre-treated, and at all stages of HIV-1 disease.Main outcome measures: Progression (defined as all new and recurrent AIDS-defining events or death) was correlated with the HIV-1 RNA level and CD4 cell count during the first 8 to 52 weeks of treatment.Results: During a median 7 year follow up, progression was largely restricted to patients with both low CD4 cell count (less than or equal to 200 x 10(6) cells/l) and high HIV-1 RNA level (> 5000 copies/ml). There was an increase in the incidence of progression events with rises in HIV-1 RNA level > 5000 copies/ml and reductions in CD4 cell count under 200 x 106 cells/l. The events occurring with HIV-1 RNA less than or equal to 5000 copies/ml were generally atypical.Conclusions: Progression to AIDS or death is rare for patients with HIV-1 RNA less than or equal to 5000 copies/ml, particularly when CD4 cell count is more than 200 x 10(6) cells/l. (C) 1998 Lippincott Williams & Wilkins.