Prognostic Indicators for AIDS and Infectious Disease Death in HIV-Infected Injection Drug Users

Abstract

CROSS-SECTIONAL STUDIES have shown that higher titers of human immunodeficiency virus type 1 (HIV-1) in peripheral blood mononuclear cells and plasma are associated with lower CD4⁺ cell counts.^1-5 Prospective studies of viral burden in persons measured soon after HIV infection (ie, seroconversion) found higher viral load to be predictive of more rapid progression of HIV-1 disease.^6-9 More relevant to the typical clinical setting, where date of onset of HIV-1 infection may be unknown to the physician, higher plasma viral load also predicts more rapid development of the acquired immunodeficiency syndrome (AIDS) and death in seroprevalent persons.^10,11 Viral load reductions in response to antiretroviral therapies are predictive of subsequent clinical response.^12,13