Predicting Progression to AIDS
Authors: Warner C. Greene
Journal: Annals of Internal Medicine (1995)

Editorials1 November 1995Predicting Progression to AIDSWarner C. Greene, MD, PhDWarner C. Greene, MD, PhDGladstone Institute of Virology and Immunology University of California, San Francisco San Francisco, CA 94141Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-9-199511010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Whom to treat, when to treat, and how to treat? These are the difficult questions faced all too frequently by clinicians caring for persons with human immunodeficiency virus (HIV) infection. Now, nearly 15 years into the expanding acquired immunodeficiency syndrome (AIDS) epidemic, we understand that HIV may produce distinctly different temporal patterns of disease progression in different persons [1, 2]. We also appreciate that the current pharmacopoeia of anti-HIV drugs is distinguished as much by its toxicity and its potential to induce drug resistance as it is by its long-term therapeutic benefit [3]. Consequently, many physicians have turned to a ...References1. Corey L, Coombs RW. The natural history of HIV infection: implications for the assessment of antiretroviral therapy. Clin Infect Dis. 1993; 16(Suppl 1):S2-6. Google Scholar2. Buchbinder SP, Katz MH, Hessol NA, O'Malley PM, Holmberg SD. Long-term HIV-1 infection without immunologic progression. AIDS. 1994; 8:1123-8. Google Scholar3. Volberding PD. Perspectives on the use of antiretroviral drugs in the treatment of HIV infection. Infect Dis Clin North Am. 1994; 8:303-17. Google Scholar4. Detels R, English PA, Giorgi JV, Visscher BR, Fahey JL, Taylor JM, et al. Patterns of CD4+ cell changes after HIV-1 infection indicate the existence of a codeterminant of AIDS. J Acquir Immune Defic Syndr. 1988; 1:390-5. Google Scholar5. Hoover DR, Graham NM, Chen B, Taylor JM, Phair J, Zhou SY, et al. Effect of CD4+ cell count measurement variability on staging HIV-1 infection. J Acquir Immune Defic Syndr. 1992; 5:794-802. Google Scholar6. Stein DS, Korvick JA, Vermund SH. CD4+ lymphocyte cell enumeration for prediction of clinical course of human immunodeficiency virus disease: a review. J Infect Dis. 1992; 165:352-63. Google Scholar7. Saksela K, Stevens C, Rubinstein P, Baltimore D. Human immunodeficiency virus type 1 mRNA expression in peripheral blood cells predicts disease progression independently of the numbers of CD4+ lymphocytes. Proc Natl Acad Sci U S A. 1994; 91:1104-8. Google Scholar8. Michael NL, Mo T, Merzouki A, O'Shaughnessy M, Oster C, Burke DS, et al. Human immunodeficiency virus type 1 cellular RNA load and splicing patterns predict disease progression in a longitudinally studied cohort. J Virol. 1995; 69:1868-77. Google Scholar9. Furtado MR, Kingsley LA, Wolinsky SM. Changes in the viral mRNA expression pattern correlate with a rapid rate of CD4+ T-cell number decline in human immunodeficiency virus type 1-infected individuals. J Virol. 1995; 69:2092-100. Google Scholar10. Saksela K, Stevens CE, Rubinstein P, Taylor PE, Baltimore D. HIV-1 messenger RNA in peripheral blood mononuclear cells as an early marker for risk for progression to AIDS. Ann Intern Med. 1995; 123:641-8. Google Scholar11. Dewar RL, Highbarger HC, Sarmiento MD, Todd JA, Vasudevachari MB, Davey RT Jr, et al. Application of branched DNA signal amplification to monitor human immunodeficiency virus type 1 burden in human plasma. J Infect Dis. 1994; 170:1172-9. Google Scholar12. Mellors JW, Kingsley LA, Rinaldo CR Jr, Todd JA, Hoo BS, Kokka RP, et al. Quantitation of HIV-1 RNA in plasma predicts outcome after seroconversion. Ann Intern Med. 1995; 122:573-9. Google Scholar13. Hogervorst E, Jurriaans S, de Wolf F, van Wijk A, Wiersma A, Valk M, et al. Predictors for non and slow progression in human immunodeficiency virus (HIV) type 1 infection: low viral RNA copy numbers in serum and maintenance of high HIV-1 p24-specific but not V3-specific antibody levels. J Infect Dis. 1995; 171:811-21. Google Scholar14. Wei X, Ghosh SK, Taylor ME, Johnson VA, Emini EA, Deutsch P, et al. Viral dynamics in human immunodeficiency virus type 1 infection. Nature. 1995; 373:117-22. Google Scholar15. Ho DD, Neumann AU, Perelson AS, Chen W, Leonard JM, Markowitz M. Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection. Nature. 1995; 373:123-6. Google Scholar16. Pantaleo G, Graziosi C, Demarest JF, Butini L, Montroni M, Fox CH, et al. HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease. Nature. 1993; 362:355-8. Google Scholar17. Embretson J, Zupancic M, Ribas JL, Burke A, Racz P, Tenner-Racz K, et al. Massive covert infection of helper T lymphocytes and macrophages by HIV during the incubation period of AIDS. Nature. 1993; 362:359-62. Google Scholar Author, Article, and Disclosure InformationAuthors: Warner C. Greene, MD, PhDAffiliations: Gladstone Institute of Virology and Immunology University of California, San Francisco San Francisco, CA 94141Acknowledgments: The author thanks Drs. J.M. McCune and J. Kahn for helpful discussions.Corresponding Author: Warner C. Greene, MD, PhD, Gladstone Institute of Virology and Immunology, P.O. Box 419100, 1310A Potrero Avenue, San Francisco, CA 94110. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHIV-1 Messenger RNA in Peripheral Blood Mononuclear Cells as an Early Marker of Risk for Progression to AIDS Kalle Saksela , Cladd E. Stevens , Pablo Rubinstein , Patricia E. Taylor , and David Baltimore Metrics Cited byNew Approaches to Using Antiretroviral Therapy for the Management of Hiv Infection 1 November 1995Volume 123, Issue 9 Page: 726-727 Keywords AIDS Blood cells Blood plasma Cells Forecasting HIV HIV infections Lymph nodes RNA Viral load ePublished: 15 August 2000 Issue Published: 1 November 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...