Relationship of CD4(+) T cell counts and HIV type 1 viral loads in untreated, infected adolescents

The REACH Project (Reaching for Excellence in Adolescent Care and Health) o f the Adolescent Medicine HIV/AIDS Research Network was designed as a study of an adolescent cohort composed of HIV-1-infected and -uninfected subject s. The goal of the analysis presented was to examine the relationship of CD 4(+) T cell counts and HIV-1 plasma viral loads in adolescents. The CD4(+) T cell counts of 84 HIV+ subjects who were 13 to 19 years of age were measu red at the clinical sites, using ACTG standardized techniques. HIV-1 viral loads in frozen plasma were determined by the NASBA/NucliSens assay at a ce ntral laboratory. Past and current treatment with antiretroviral drugs was determined by medical record abstraction and interview data. The slope of t he line generated by regressing log(10) HIV-1 RNA (copies/ml) versus CD4(+) T cell counts of REACH subjects who are antiretroviral drug naive was nega tive and significantly different than zero. A negative association has also been reported for antiretroviral drug-naive, adult males in the Pittsburgh Men's Study, a component of MACS (Pitt-MACS) (Mellors J, et al.: Science 1 996;272:1167). These data show that in adolescents, as in adults, HIV-1 RNA concentrations are correlated with corresponding absolute CD4(+) T cell co unt. The slopes of the lines generated with data from each cohort were diff erent (p = 0.003). In addition to age, there are sex and racial differences in the makeup of the two cohorts. Any or all of these differences may affe ct the slopes of the lines.