HIV RNA Levels Minimally Predictive for CD4 Decline

Other factors influence CD4 cell loss in untreated people

TUESDAY, Sept. 26 (HealthDay News) -- In untreated disease, plasma HIV RNA levels have only a minimally predictive value for CD4 cell decline rate, according to a report in the Sept. 27 issue of the Journal of the American Medical Association.

Benigno Rodriguez, M.D., of the Center for AIDS Research, Case Western Reserve University in Cleveland, and colleagues analyzed two HIV-infected cohorts. In one group, 1,289 patients were chronically infected and were antiretroviral treatment-naive; the other group had 1,512 such patients. Both groups were untreated for the six-month observation period.

Despite a trend toward higher CD4 cell loss with higher presenting HIV RNA levels, just a small proportion of CD4 cell loss variability was actually linked to plasma HIV RNA levels. Multiple measurements and restricting the analysis to patients with high HIV RNA levels improved the correlation minimally.

"The results of our study challenge the concept that CD4 cell depletion in chronic HIV infection is mostly attributable to the direct effects of HIV replication. Future efforts to delineate the relative contribution of other mechanisms will be crucial to the understanding of HIV immunopathogenesis and to the ability to attenuate it," the authors conclude.

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