THE PROGNOSTIC VALUE OF PLASMA VIREMIA IN HIV-INFECTED PATIENTS UNDERAZT TREATMENT - A 2-YEAR FOLLOW-UP-STUDY

To determine the prognostic value of plasma viremia in long-term zidov udine (AZT)-treated HIV-infected patients, HIV-1 plasma viremia (PV) w as quantified in 28 HIV-infected patients before and during AZT long-t erm treatment; the follow-up also included p23 antigenemia and CD4 cel l counts. The variations of these markers during the follow-up period, the correlation with the clinical outcome (progressors versus nonprog ressors), and the discrepancies between PV and surrogate markers were then analyzed. A significant and stable decrease in PV titer was obser ved in only nonprogressors (Friedman test, p < 0.005). At the end of f ellow-up, 11 (73%) of the 15 nonprogressors were PV responders (patien ts who remained or became PV- longterm), whereas all the 13 progressor s were PV nonresponders (patients who remained or became PV+). These r esults indicated a strong correlation between PV and clinical outcome (Fischer's exact test, p < 0.0001). The persistence, increase, or reap pearance oi viral replication appeared to be an important predictor of poor clinical outcome in HIV-infected patients under AZT treatment. T his finding could provide a rational basis to help the clinician's dec ision in the clinical treatment of HIV-infected patients.