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

Abstract

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.

HIV-1 viral load, phenotype, and resistance in a subset of drug-naive participants from the Delta trial

“…18,19 The virology substudy of 391 participants in trial ACTG175 (216 zidovudine-naive patients) assayed viral load at only five time points (two at baseline). monotherapy group (20% and 93%), one in the zidovudine plus zalcitabine group (98%).…”

Viraemia and HIV-1 drug resistance mutations among patients receiving antiretroviral treatment in Mozambique

“…If viral suppression is not achieved for whatever reason, the chronology of events is that the viral load increases to detectable levels, leading in a second step to a significant drop in CD4 count (immunological failure) and the development of new or recurrent opportunistic infections (clinical failure). 4 A detectable viral load implies ongoing viral replication, which fosters the development of drug-resistant mutations and constitutes a major potential problem for the future of ART in Africa. 4,5 Viral load monitoring, which typically measures HIV-1 RNA concentrations in plasma, is the most reliable method for detecting adherence problems and early treatment failure.…”

“…4 A detectable viral load implies ongoing viral replication, which fosters the development of drug-resistant mutations and constitutes a major potential problem for the future of ART in Africa. 4,5 Viral load monitoring, which typically measures HIV-1 RNA concentrations in plasma, is the most reliable method for detecting adherence problems and early treatment failure. In industrialized countries, individuals on ART have both viral load and CD4 levels measured regularly as part of routine follow-up.…”

Therapy and Prophylaxis in Human Immunodeficiency Virus (Hiv) Infection

“…The level of HIV RNA in plasma has been shown to be the strongest predictor of outcome over 1-10 years period of observation [12]. The level of mv RNA expression in lymphoid tissue may be higher and more intense than suggested by plasma concentration.…”