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1994-08-27
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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).