CORRELATION BETWEEN SURROGATE MARKERS, VIRAL LOAD, AND DISEASE PROGRESSION IN HIV-1 INFECTION

Surrogate markers generally used for observation of patients infected with human immunodeficiency virus (HIV) and their plasma and cellular viral load were assayed in a series of 40 patients before initiation o f zidovudine therapy. Plasma viremia was positive in 62.5% of patients and was statistically correlated with clinical stage, CD4(+) T cell c ount, CD8(+) T cell count, beta(2)-microglobulin level, neopterin leve l, and immunoglobulin A level. Cellular viremia was positive in 95% of patients and was correlated with clinical stage, CD4(+) T cell count, beta(2)-microglobulin, neopterin levels, and disease progression duri ng the following months. A discordance was found between p24 antigenem ia, even after acid dissociation of immune complexes, and plasma virem ia. In fact, p24 antigenemia was correlated with only biological marke rs of immune activation as beta(2)-microglobulin and neopterin levels. The measurement of anti-p24 antibodies did not appear discriminative in our staging. Plasma viremia, like CD4(+) T cell count, reflects the patient's status at the time of assessment. Cellular viremia could be more informative for the prediction of future clinical progression.