The relative prognostic value of plasma HIV RNA levels and CD4 lymphocyte counts in advanced HIV infection

Abstract

It has been suggested that the plasma HIV RNA level is a better predictor of AIDS and death than the CD4 lymphocyte count. We assessed whether the prognostic value of plasma virus levels was different according to the CD4 count. Prospective cohort study of HIV-infected patients followed for a median of 2.91 years (range, 0.02–4.54). Department of Infectious Diseases at Rigshospitalet, Copenhagen, Denmark. A group of 255 HIV-infected individuals with an initial measurement of CD4 lymphocyte count and plasma HIV RNA. Survival time. The plasma HIV RNA (median 101 410 copies/ml; range (range 200–7 200 000) and the CD4 lymphocyte count (median 250 cells × 106/l; range 1–1247) were negatively correlated (Pearson r = −0.53; P P Patients were relatively lightly treated with antiretroviral drugs both before and during this study. In this situation, it appears that the HIV RNA level has a relatively weak association with risk of death in patients with advanced HIV infection and that the CD4 lymphocyte count is probably more useful in assessing prognosis.