Goudsmit J
Human Retrovirus Laboratory, Academic Medical Centre, Amsterdam, The Netherlands.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995;10 Suppl 1:S15-9.
From the time of seroconversion, patients who retain a high viral load are known to progress more rapidly to AIDS than individuals who have lower levels of HIV. Increased viral load is accompanied by decreasing CD4 cell numbers, and CD4 cell counts are therefore widely used as a diagnostic marker or predictor of progression in HIV patients. During the asymptomatic phase, however, CD4 counts often remain in the "normal" range, and this marker provides little information on potential disease progression. A shift in viral phenotype from non-syncytium-inducing (NSI) to syncytium-inducing (SI) heralds disease progression, and early in infection SI progression can be distinguished from nonprogression on the basis of CD4 changes. NSI progression, on the other hand, cannot be distinguished from nonprogression on the basis of CD4 counts but can be distinguished on the basis of RNA load. Molecular assessment of viral phenotype, such as quantitative measures of HIV RNA, as well as syncytium-inducing and nonsyncytium-inducing is therefore able to provide valuable information on the probable course of progression in individual patients, thus aiding in more effective disease management.
从血清转化之时起，已知病毒载量高的患者比HIV水平较低的个体更快发展为艾滋病。病毒载量增加伴随着CD4细胞数量减少，因此CD4细胞计数被广泛用作HIV患者病情进展的诊断标志物或预测指标。然而，在无症状期，CD4计数通常保持在“正常”范围内，该标志物几乎无法提供有关潜在疾病进展的信息。病毒表型从非合胞体诱导型（NSI）转变为合胞体诱导型（SI）预示着疾病进展，在感染早期，可根据CD4变化将SI进展与无进展区分开来。另一方面，NSI进展无法根据CD4计数与无进展区分，但可根据RNA载量区分。因此，对病毒表型进行分子评估，如对HIV RNA的定量测量以及合胞体诱导型和非合胞体诱导型的评估，能够为个体患者的可能进展过程提供有价值的信息，从而有助于更有效地管理疾病。
