Emery V C, Sabin C, Feinberg J E, Grywacz M, Knight S, Griffiths P D
Department of Virology and HIV Research Unit, Royal Free and University College School of Medicine, London, NW3 2QG UK.
J Infect Dis. 1999 Sep;180(3):695-701. doi: 10.1086/314936.
Virus load is a major risk factor for disease in many human viral infections, especially human immunodeficiency virus (HIV) disease. The effect of cytomegalovirus (CMV) load on disease progression and the influence of antiviral chemotherapy on surrogate markers of replication was investigated in 310 patients with advanced HIV disease in a randomized controlled trial that compared the effects of valacyclovir with those of acyclovir. Sequential blood and urine samples were analyzed by polymerase chain reaction (PCR), for human CMV (HCMV) DNA. In multivariate analyses, elevated virus load in both blood and urine at baseline was associated with increased risk of HCMV disease (relative hazard, 1.49 and 1.44 per log increase, respectively). Elevated virus load in blood at baseline was also associated with a significantly shorter survival time (log rank, P=. 0001). In time-updated analyses, valacyclovir significantly suppressed the virus load in subjects who were PCR positive at baseline (in blood or urine), when compared with the combined acyclovir arms.
病毒载量是许多人类病毒感染（尤其是人类免疫缺陷病毒（HIV）疾病）中疾病的主要危险因素。在一项随机对照试验中，对310例晚期HIV疾病患者进行了研究，比较了伐昔洛韦与阿昔洛韦的效果，以探讨巨细胞病毒（CMV）载量对疾病进展的影响以及抗病毒化疗对复制替代标志物的影响。通过聚合酶链反应（PCR）对连续采集的血液和尿液样本进行人巨细胞病毒（HCMV）DNA分析。在多变量分析中，基线时血液和尿液中病毒载量升高与HCMV疾病风险增加相关（每增加一个对数，相对风险分别为1.49和1.44）。基线时血液中病毒载量升高也与显著缩短的生存时间相关（对数秩检验，P = 0.0001）。在时间更新分析中，与联合使用阿昔洛韦的组相比，伐昔洛韦在基线时PCR呈阳性（血液或尿液中）的受试者中显著抑制了病毒载量。
