Longitudinal human immunodeficiency virus type 1 load in the Italian seroconversion study: Correlates and temporal trends of virus load

A prospective study of 149 human immunodeficiency virus type 1 (HIV-1) sero converters was conducted to describe trends and correlates of HIV-1 load af ter seroconversion and over time. HIV-1 load was quantified from frozen ser a by reverse transcriptase-polymerase chain reaction. High early virus load was associated with lower CD4 cell counts and male sex but not with age at seroconversion or injection drug use. Early virus load predicted progressi on to clinical AIDS and AIDS/<200 CD4 cells/mu L. Virus load exhibited a de cline of 52% by 18 months after seroconversion then increased 23% annually (95% confidence interval, 13%-33%). Men and those developing AIDS during fo llow-up had higher virus loads over the course of disease. Persons who deve loped AIDS had a steeper virus load slope than those who were AIDS-free (P = .01). In long-term follow-up, virus load exhibited a gradual and sustaine d increase over time. Virus load and annual increase are strong predictors of disease progression.