Lathey J L, Hughes M D, Fiscus S A, Pi T, Jackson J B, Rasheed S, Elbeik T, Reichman R, Japour A, D'Aquila R T, Scott W, Griffith B P, Hammer S M, Katzenstein D A
Department of Pediatrics, University of California, San Diego, La Jolla 92093-0672, USA.
J Infect Dis. 1998 Mar;177(3):617-24. doi: 10.1086/514250.
Virologic measurements are increasingly used to evaluate prognosis and treatment responses in human immunodeficiency virus (HIV) type 1 infection. Markers of HIV-1 replication, including infectious HIV-1 titer from peripheral blood mononuclear cells, serum HIV-1 p24 antigen, plasma HIV-1 RNA, CD4 cell numbers, and viral syncytium-inducing (SI) phenotype, were determined in 391 virology substudy participants in AIDS Clinical Trials Group study 175. The subjects had 200-500 CD4 cells/mm3. All markers of viral replication significantly correlated with one another and were inversely related to CD4 cell number. Disease progression to an AIDS-defining event or death or loss of >50% of CD4 cells was associated with infectious HIV-1 titer (P < .001), HIV-1 RNA (P < .001), and HIV-1 p24 antigen (P = .007). In multivariate proportional hazards models, p24 antigen was never significant when HIV-1 RNA level was included. In a model containing infectious HIV-1 titer (P = .038), HIV-1 RNA (P < .001), SI phenotype (P < .001), and CD4 cell number (P = .18), only the virologic parameters remained significantly associated with progression.
病毒学检测越来越多地用于评估1型人类免疫缺陷病毒（HIV）感染的预后和治疗反应。在艾滋病临床试验组175研究的391名病毒学亚研究参与者中，测定了HIV-1复制的标志物，包括外周血单核细胞中具有传染性的HIV-1滴度、血清HIV-1 p24抗原、血浆HIV-1 RNA、CD4细胞数量和病毒合胞体诱导（SI）表型。受试者的CD4细胞计数为200 - 500个/mm³。所有病毒复制标志物之间均显著相关，且与CD4细胞数量呈负相关。疾病进展至艾滋病定义事件、死亡或CD4细胞减少>50%与具有传染性的HIV-1滴度（P <.001）、HIV-1 RNA（P <.001）和HIV-1 p24抗原（P =.007）相关。在多变量比例风险模型中，当纳入HIV-1 RNA水平时，p24抗原从未具有显著性。在一个包含具有传染性的HIV-1滴度（P =.038）、HIV-1 RNA（P <.001）、SI表型（P <.001）和CD4细胞数量（P =.18）的模型中，只有病毒学参数与疾病进展仍显著相关。
