A. Ruffault et al., THE PROGNOSTIC VALUE OF PLASMA VIREMIA IN HIV-INFECTED PATIENTS UNDERAZT TREATMENT - A 2-YEAR FOLLOW-UP-STUDY, Journal of acquired immune deficiency syndromes and human retrovirology, 9(3), 1995, pp. 243-248
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.