MARKERS PREDICTING PROGRESSION OF HUMAN IMMUNODEFICIENCY VIRUS-RELATED DISEASE

Human immunodeficiency virus (HIV) interacts with the immune system th roughout the course of infection. For most of the disease process, HIV activates the immune system, and the degree of activation can be asse ssed by measuring serum levels of molecules such as beta(2)-microglobu lin and neopterin, as well as other serum and cell surface phenotype m arkers. The levels of same of these markers correlate with clinical pr ogression of Hrv disease, and these markers may be useful as surrogate markers for development of clinical AIDS. Because the likelihood and timing of development of clinical AIDS following seroconversion, for a ny particular individual, are not readily predictable the use of noncl inical disease markers has become critically important to patient mana gement. Surrogate markers of HN infection are, by definition, measurab le traits that correlate with disease progression. An ideal marker sho uld identify patients at highest risk of disease progression, provide information on how long an individual has been infected help in stagin g HN disease, predict development of opportunistic infections associat ed with AIDS, monitor the therapeutic efficacy of immunomodulating or antiviral treatments, and be easily quantifiable, reliable, clinically available, and affordable. This review examines the current state of knowledge and the role of surrogate markers in the natural history and treatment of HN infection. The clinical usefulness of each marker is assessed with respect to the criteria outlined for the ideal surrogate marker for HIV disease progression.