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Abstract
VIRAL LOAD, PERCENTAGE CD4 CELL COUNT AND SURVIVAL IN HIV MONOTYPIC AND DUAL INFECTIONS IN WEST AFRICA
ALABI S, BLANCHARD T, SHABBAR J, CORRAH T, ARIYOSHI K, BERRY N, WHITTLE H
Background: Studies from developed countries have shown plasma viraemia as an excellent maker of prognosis in HIV-1 infections. However, it is not known whether plasma viraemia is an independent predictor of mortality in HIV-1 infected African people, or how the death rates in HIV-1 and HIV-2 differ after taking plasma viraemia and percentage CD4 cell count (CD4%) into account. This hospital-based study addresses these questions.
Methods: We measured baseline plasma viraemia (RNA copies/ml) in a total of 256 (119 HIV-1 and 137 HIV-2) singly infected and 81 individuals dually infected with both viruses (HIV-D). Subjects were part of a clinical cohort of HIV infected individuals seen at our clinic, enrolled between 1991 and 1997, and followed-up through 2000. Survival was established by home visits if subjects did not present to clinic during a quarterly check-up schedule. HIV status was established by serology and by PCR; and CD4% was measured by FACScan.
Results: HIV-1 plasma viraemia among singly infected individuals were similar to that of dually infected (p=0.5), and similar trend for HIV-2 (p=0.7). Mean CD4% was significantly lower in dual infections than in either HIV-1 or HIV-2 infected subjects. Death rates of dually infected subjects were significantly higher than that in HIV-2 but similar to that in HIV-1 with hazard ratios (95% CI) of 1.54 (1.08, 2.19; p=0.02) and 1.25 (0.88, 1.77; p=0.2) respectively.
Conclusions: Both plasma viraemia and CD4% were independently associated with survival in HIV-2 infection, while only CD4% was independently associated with survival in HIV-1 and in dual infections. After adjusting for plasma viraemia and CD4%, survival in HIV-1 or HIV-2 infected individuals did not differ significantly. Our findings give new insight into how these two viruses differ; and may provide the means with which patients are better counselled about their prognosis, and by which therapies might be tested and monitored.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
16
Suggested Citation
"ALABIS, et al.
VIRAL LOAD, PERCENTAGE CD4 CELL COUNT AND SURVIVAL IN HIV MONOTYPIC AND DUAL INFECTIONS IN WEST AFRICA.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
16"
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