Document 0715
 DOCN  M9480715
 TI    [Replication indexes of the human immunodeficiency virus: predictive
       value of viral culture and blood antigens]
 DT    9410
 AU    Carton JA; Melon S; Maradona JA; de Ona M; Asensi V; Martinez A; Carcaba
       V; Servicio de Medicina Interna, Enfermedades Infecciosas, Hospital;
       Central de Asturias (Hospital Nuestra Senora de Covadonga),; Universidad
       de Oviedo.
 SO    Med Clin (Barc). 1994 May 21;102(19):725-30. Unique Identifier :
       AIDSLINE MED/94315956
 AB    BACKGROUND: To investigate the relation between markers of load and
       replication of the HIV [viral culture in plasma and in mononuclear cells
       of peripheral blood (MCPB) and antigen p24 (p24Ag) with the number of
       CD4+ cells and the prognosis of the patients. METHODS: A retrospective
       study was performed in 188 patients who were analyzed and followed over
       a mean period of 431 days. The criteria of clinical progression (AIDS
       related complex, and new opportunistic infections), immunologic
       progression (CD4+ < 0.1 and < 0.05 + 10(9)/l) and death. Cocultures of
       HIV in free plasma and in MCPB were performed with the detection of
       complete AgHIV in the supernatant of the culture being used for
       analysis. Circulating p24Ag was determined by an ELISA technique without
       previous dissociation of the immunocomplexes. RESULTS: HIV cultures in
       plasma, in MCPB and p24Ag were positive in 27, 48 and 33% of the
       patients, respectively. The sensitivity of the indexes increased in
       agreement with the clinical progression of the patients and was
       inversely proportional to the depletion of the CD4+ lymphocytes (79% of
       the patients with CD4+ lymphocytes < 0.05 x 10(9)/l presented positive
       HIV culture in plasma). Viremia in plasma and to a lesser measure p24Ag
       correlated with variables recognized as bad prognosis and were found to
       be predictive of unfavorable evolution. Multivariate analysis
       demonstrated that pertenence to a symptomatic group and the presentation
       of a number of CD4+ lymphocytes of less than 0.2 x 10(9)/l were
       independent factors associated to the positivity of the viral culture in
       plasma and p24Ag. The culture positive in MCPB was principally related
       with the volume of blood analyzed. The risk of death was 6.38 fold
       greater in the presence of a positive plasma culture and 2.02 fold
       greater in the presence of positive p24Ag. In contrast, the unquantified
       positive HIV culture in MCPB showed no statistical significance in
       relation with patient survival. CONCLUSIONS: Positive HIV culture in
       plasma was the greatest prognostic index in patients with a number of
       CD4+ lymphocytes less than 0.2 x 10(9)/l. Unquantified cell culture had
       no predictive significance. To establish the prognosis of patients, the
       indexes of viral replication should not be used in isolation.
 DE    Acquired Immunodeficiency Syndrome/*BLOOD/*MICROBIOLOGY/MORTALITY
       Actuarial Analysis  Adolescence  Adult  Aged  English Abstract  Female
       Human  HIV/*PHYSIOLOGY  HIV Core Protein p24/*BLOOD  HIV
       Seropositivity/*BLOOD/*MICROBIOLOGY/MORTALITY  Leukocytes,
       Mononuclear/*MICROBIOLOGY  Male  Middle Age  Multivariate Analysis
       Predictive Value of Tests  Prognosis  Retrospective Studies  Severity of
       Illness Index  Survival Rate  Virology/METHODS  *Virus Replication
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).