HIV replication capacity is an independent predictor of disease progression in persons with untreated chronic HIV infection

Matthew Bidwell Goetz, Robert Leduc, Nicole Wyman, Jay R. Kostman, Ann M. Labriola, Yolanda Lie, Jodi Weidler, Eoin Coakley, Michael Bates, Roberta Luskin-Hawk

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

OBJECTIVE: To assess the effect of pol replication capacity (RC) on the hazard ratio of progression to a composite endpoint of time to progression to <350 CD4+ cells per microliter, initiation of therapy, or death. METHODS: pol RC assays were performed after study closure in baseline samples obtained from 316 enrollees in a prospectively monitored cohort of treatment-naive adults with ≥450 CD4+ cells per microliter and ≥1000 HIV-1 RNA copies per milliliter. RESULTS: The median RC was 79%. Patients with a lower RC had a lower median viral load (4.0 vs 4.2 Log HIV-1 RNA copies/mL, P = 0.026) and a lower rate of protease inhibitor resistance 2% vs 8%, P = 0.03). Otherwise, baseline demographic and laboratory characteristics were similar. The hazard ratio of progression to the composite endpoint was 0.73 (P = 0.041) for persons with lower RC, 2.07 per 1.0 log10 higher viral load (P < 0.001), and 0.86 per 50 cells per microliter higher CD4 cell count (P < 0.001). The effect of lower RC was also significant in a separate analysis of time to initiation of therapy (P = 0.04). CONCLUSIONS: These results show that untreated patients with lower vs higher RC had a slower rate of progression as assessed by a composite outcome of time to CD4 count ≤350 cells per microliter, treatment initiation, or death.

Original languageEnglish (US)
Pages (from-to)472-479
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume53
Issue number4
DOIs
StatePublished - Apr 2010

Keywords

  • Disease progression
  • HIV infections
  • Natural history
  • Replication

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