Luque F, Caruz A, Pineda J A, Torres Y, Larder B, Leal M
Department of Biochemistry and Internal Medicine, Virgen del Rocio Universitary Hospital, Seville, Spain.
J Infect Dis. 1994 Feb;169(2):267-73. doi: 10.1093/infdis/169.2.267.
Human immunodeficiency virus type 1 (HIV-1) provirus burden was quantified during follow-up of untreated patients and mathematically analyzed by a parameter called intrinsic rate of increase (r). There was an increase in provirus burden in patients at early stages of the infection, and the increase occurred at a similar rate in later stages of the disease. Antiviral response to zidovudine was evaluated using r. Nearly 50% of patients responded with strong decreases of r, and the rest behaved as nonresponders. Parameter r is valuable in disease prognosis, as the mean r was higher in disease progressors than in nonprogressors, and this difference was significant and more pronounced in treated patients. The zidovudine resistance mutation at codon 215 of reverse transcriptase was associated with a worse response to therapy. Absence of antiviral response and resistance mutations were more frequent in patients with lower CD4+ cell counts and higher provirus loads. These findings support a more beneficial effect of early than late therapy.
在未经治疗的患者随访期间对1型人类免疫缺陷病毒（HIV-1）前病毒负荷进行了定量，并通过一个称为内在增长率（r）的参数进行数学分析。在感染早期患者的前病毒负荷增加，且在疾病后期以相似速率增加。使用r评估对齐多夫定的抗病毒反应。近50%的患者r大幅下降，其余患者则无反应。参数r在疾病预后方面具有价值，因为疾病进展者的平均r高于未进展者，且这种差异在接受治疗的患者中显著且更明显。逆转录酶第215位密码子的齐多夫定耐药突变与治疗反应较差相关。在CD4+细胞计数较低和前病毒载量较高的患者中，无抗病毒反应和耐药突变更为常见。这些发现支持早期治疗比晚期治疗更有益。
