Hodara V L, Monticelli A, Benetucci J, Lasala M, Jauregui Rueda H, Libonatti O, García Messina O, Reboredo G, Bogdanowicz E, Bases O, Pampuro S, Salomón H
Departamento de Microbiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay, Argentina.
Rev Argent Microbiol. 1998 Jan-Mar;30(1):1-7.
The evaluation of viral load as virological marker and its clinical and immunological correlation are presented. The first viral load studies were performed during 1996 at the National Reference Center for AIDS in Argentina in HIV-1 positive patients derived from different Hospitals in Buenos Aires. The study included 216 HIV-1 positive patients, 49 females and 167 males. Plasma was used for evaluating viral load and a second sample was obtained in 25 of the 216 patients for their monitoring. Viral load was performed using bDNA technique (Quantiplex HIV RNA assay 2.0, Chiron Corporation, USA). Other parameters such as CD4 count determined by flow cytometry and clinical stages according to CDC classification were obtained in order to correlate clinical and immunological status of the patients. When CD4 count was compared with viral load, the results showed a trend of viral RNA increase in plasma along with a decrease in CD4+ lymphocytes. This trend was also observed to correlate with the progression to AIDS disease. In all groups of patients, considering either CD4 counts or clinical status, ranges of viral load values were broad. Thus, as shown by percentiles 25 and 75, patients with CD4 counts < 200/ml, presented viral load values between 18,395 c/ml to 215,425 c/ml and patients with > 200/ml viral RNA showed values from < 10,000 to 35,180 c/ml. Patients with CDC's A and B stages presented values from < 10,000 to 45,160 c/ml and 87,000 c/ml respectively, while patients classified as C had 10,582 to 215,000 c/ml. Results of two consecutive samples in the 25 patients showed the usefulness of this technique for monitoring antiretroviral therapy. Nevertheless, despite the tendency of viral load to increase along with the progression of the disease, the broad range of values suggested the importance of using both virological and immunological parameters for the management of HIV infected patients.
本文介绍了作为病毒学标志物的病毒载量评估及其临床和免疫学相关性。最早的病毒载量研究于1996年在阿根廷国家艾滋病参考中心对来自布宜诺斯艾利斯不同医院的HIV-1阳性患者进行。该研究纳入了216名HIV-1阳性患者，其中49名女性，167名男性。采用血浆评估病毒载量，并在216名患者中的25名患者身上采集了第二份样本用于监测。使用bDNA技术（美国Chiron公司的Quantiplex HIV RNA检测试剂盒2.0）检测病毒载量。还获取了其他参数，如通过流式细胞术测定的CD4细胞计数以及根据美国疾病控制与预防中心（CDC）分类的临床分期，以便关联患者的临床和免疫状态。当将CD4细胞计数与病毒载量进行比较时，结果显示血浆中病毒RNA水平升高的同时CD4+淋巴细胞数量减少。这种趋势也与艾滋病病情进展相关。在所有患者组中，无论考虑CD4细胞计数还是临床状态，病毒载量值的范围都很宽泛。因此，如第25和第75百分位数所示，CD4细胞计数<200/ml的患者，病毒载量值在18,395拷贝/ml至215,425拷贝/ml之间，而病毒RNA>200/ml的患者，病毒载量值在<10,000至35,180拷贝/ml之间。处于CDC A期和B期的患者，病毒载量值分别在<10,000至45,160拷贝/ml和87,000拷贝/ml之间，而分类为C期的患者，病毒载量值在10,582至215,000拷贝/ml之间。25名患者连续两份样本的结果表明该技术在监测抗逆转录病毒治疗方面的有效性。然而，尽管病毒载量有随疾病进展而升高的趋势，但宽泛的值范围表明在管理HIV感染患者时同时使用病毒学和免疫学参数的重要性。
