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M94A2380.TXT
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1994-10-25
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Document 2380
DOCN M94A2380
TI Viral burden, antiviral immune response, and nonspecific immune
activation in predicting progression of HIV disease.
DT 9412
AU Ascher MS; Sheppard HW; Lang W; Busch MP; Lee TH; Calif. Dept. Health
Serv. Berkeley 94704.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):317 (abstract no. PC0200). Unique
Identifier : AIDSLINE ICA10/94370195
AB OBJECTIVE: To assess the predictive value of serial measurements of
viral burden, immune response and markers of immune activation on HIV
disease progression in the San Francisco Men's Health Study cohort.
METHODS: A balanced sample of 26 individuals representing four patterns
of risk of progression based on previous studies of immune activation
and immune response was selected. Blood samples from study entry in 1984
and the five year followup visit in 1989 were tested for levels of
anti-p24 immune response by a serial dilution ELISA method, for serum
neopterin and beta-2 microglobulin and for levels of virus by
quantitative DNA PCR. These results were analyzed and correlated with
the slope of CD4 cell decline and the incidence of AIDS defining
conditions as the endpoints. RESULTS: As previously noted, the initial
levels of anti-p24 antibody and neopterin were highly predictive of
progression at five years of followup and showed no differential change
over time in progressors and nonprogressors. Viral burden was a somewhat
stronger predictor compared to its inverse, the p24 antibody titer.
Beta-2 microglobulin levels were not different (or predictive) at study
onset, but increased dramatically in progressed individuals, resulting
in this marker being the strongest correlate of progression. The
multivariate discriminant model combining these variables correctly
classified 87% of individuals' disease outcome. DISCUSSION AND
CONCLUSIONS: Two major variables in the HIV disease process, the viral
burden and degree of immune activation, appear to be determined shortly
after infection and change very little thereafter. Initial levels are
strongly predictive of disease progression. Direct measurement of viral
burden is slightly more predictive than the inversely related antiviral
immune response, but has far greater cost and complexity. One immune
activation marker, neopterin, was a better predictor than a second
marker, beta-2 microglobulin, which in turn was the strongest correlate
of the progressed state.
DE beta 2-Microglobulin/ANALYSIS Biological Markers/BLOOD
Biopterin/ANALOGS & DERIVATIVES/BLOOD Enzyme-Linked Immunosorbent Assay
Human HIV/ISOLATION & PURIF HIV Core Protein p24/ANALYSIS HIV
Infections/IMMUNOLOGY/MICROBIOLOGY/*PATHOLOGY Male Polymerase Chain
Reaction Prognosis MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).