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Science 24 May 1996:
Vol. 272. no. 5265, pp. 1167 - 1170
DOI: 10.1126/science.272.5265.1167

Reports

Prognosis in HIV-1 Infection Predicted by the Quantity of Virus in Plasma

John W. Mellors, * Charles R. Rinaldo Jr., Phalguni Gupta, Roseanne M. White, John A. Todd, Lawrence A. Kingsley

The relation between viremia and clinical outcome in individuals infected with human immunodeficiency virus-type 1 (HIV-1) has important implications for therapeutic research and clinical care. HIV-1 RNA in plasma was quantified with a branched-DNA signal amplification assay as a measure of viral load in a cohort of 180 seropositive men studied for more than 10 years. The risk of acquired immunodeficiency syndrome (AIDS) and death in study subjects, including those with normal numbers of CD4+ T cells, was directly related to plasma viral load at study entry. Plasma viral load was a better predictor of progression to AIDS and death than was the number of CD4+ T cells.

J. W. Mellors, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; and Veterans Affairs Medical Center, Pittsburgh, PA 15240, USA.
C. R. Rinaldo Jr., Department of Pathology, School of Medicine, and Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
P. Gupta, Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
R. M. White and J. A. Todd, Chiron Corporation, Emeryville, CA 94608, USA.
L. A. Kingsley, Department of Infectious Diseases and Microbiology and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
* To whom correspondence should be addressed at University of Pittsburgh Graduate School of Public Health, 403 Parran Hall, Pittsburgh, PA 15261, USA.



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   Abstract »    Full Text »    PDF »
Divergent Host Responses during Primary Simian Immunodeficiency Virus SIVsm Infection of Natural Sooty Mangabey and Nonnatural Rhesus Macaque Hosts.
G. Silvestri, A. Fedanov, S. Germon, N. Kozyr, W. J. Kaiser, D. A. Garber, H. McClure, M. B. Feinberg, and S. I. Staprans (2005)
J. Virol. 79, 4043-4054
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Characterization of functional and phenotypic changes in anti-Gag vaccine-induced T cell responses and their role in protection after HIV-1 infection.
M. R. Betts, B. Exley, D. A. Price, A. Bansal, Z. T. Camacho, V. Teaberry, S. M. West, D. R. Ambrozak, G. Tomaras, M. Roederer, et al. (2005)
PNAS 102, 4512-4517
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Signature for Long-Term Vaccine-Mediated Control of a Simian and Human Immunodeficiency Virus 89.6P Challenge: Stable Low-Breadth and Low-Frequency T-Cell Response Capable of Coproducing Gamma Interferon and Interleukin-2.
S. Sadagopal, R. R. Amara, D. C. Montefiori, L. S. Wyatt, S. I. Staprans, N. L. Kozyr, H. M. McClure, B. Moss, and H. L. Robinson (2005)
J. Virol. 79, 3243-3253
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Detection of Antibody-Dependent Complement-Mediated Inactivation of both Autologous and Heterologous Virus in Primary Human Immunodeficiency Virus Type 1 Infection.
M. M. I. Aasa-Chapman, S. Holuigue, K. Aubin, M. Wong, N. A. Jones, D. Cornforth, P. Pellegrino, P. Newton, I. Williams, P. Borrow, et al. (2005)
J. Virol. 79, 2823-2830
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Cost-Effectiveness of Screening for HIV in the Era of Highly Active Antiretroviral Therapy.
G. D. Sanders, A. M. Bayoumi, V. Sundaram, S. P. Bilir, C. P. Neukermans, C. E. Rydzak, L. R. Douglass, L. C. Lazzeroni, M. Holodniy, and D. K. Owens (2005)
N. Engl. J. Med. 352, 570-585
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Evaluation of Two Commercially Available, Inexpensive Alternative Assays Used for Assessing Viral Load in a Cohort of Human Immunodeficiency Virus Type 1 Subtype C-Infected Patients from South Africa.
G. Stevens, N. Rekhviashvili, L. E. Scott, R. Gonin, and W. Stevens (2005)
J. Clin. Microbiol. 43, 857-861
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A Dominant Role for CD8+-T-Lymphocyte Selection in Simian Immunodeficiency Virus Sequence Variation.
D. H. O'Connor, A. B. McDermott, K. C. Krebs, E. J. Dodds, J. E. Miller, E. J. Gonzalez, T. J. Jacoby, L. Yant, H. Piontkivska, R. Pantophlet, et al. (2004)
J. Virol. 78, 14012-14022
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Determinants of Human Immunodeficiency Virus Type 1 Escape from the Primary CD8+ Cytotoxic T Lymphocyte Response.
N. A. Jones, X. Wei, D. R. Flower, M. Wong, F. Michor, M. S. Saag, B. H. Hahn, M. A. Nowak, G. M. Shaw, and P. Borrow (2004)
J. Exp. Med. 200, 1243-1256
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Direct Inoculation of Simian Immunodeficiency Virus from Sooty Mangabeys in Black Mangabeys (Lophocebus aterrimus): First Evidence of AIDS in a Heterologous African Species and Different Pathologic Outcomes of Experimental Infection.
C. Apetrei, B. Gormus, I. Pandrea, M. Metzger, P. ten Haaft, L. N. Martin, R. Bohm, X. Alvarez, G. Koopman, M. Murphey-Corb, et al. (2004)
J. Virol. 78, 11506-11518
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Attenuated Central Nervous System Infection in Advanced HIV/AIDS With Combination Antiretroviral Therapy.
J. C. McArthur, M. P. McDermott, D. McClernon, C. St Hillaire, K. Conant, K. Marder, G. Schifitto, O. A. Selnes, N. Sacktor, Y. Stern, et al. (2004)
Arch Neurol 61, 1687-1696
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Predicting the Impact of a Nonsterilizing Vaccine against Human Immunodeficiency Virus.
M. P. Davenport, R. M. Ribeiro, D. L. Chao, and A. S. Perelson (2004)
J. Virol. 78, 11340-11351
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Primary HIV-1 Infection Is Associated with Preferential Depletion of CD4+ T Lymphocytes from Effector Sites in the Gastrointestinal Tract.
S. Mehandru, M. A. Poles, K. Tenner-Racz, A. Horowitz, A. Hurley, C. Hogan, D. Boden, P. Racz, and M. Markowitz (2004)
J. Exp. Med. 200, 761-770
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Kinetics of Virus-Specific CD8+ T Cells and the Control of Human Immunodeficiency Virus Infection.
M. P. Davenport, R. M. Ribeiro, and A. S. Perelson (2004)
J. Virol. 78, 10096-10103
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From the Cover: Quantifiable cytotoxic T lymphocyte responses and HLA-related risk of progression to AIDS.
A. Scherer, J. Frater, A. Oxenius, J. Agudelo, D. A. Price, H. F. Gunthard, M. Barnardo, L. Perrin, B. Hirschel, R. E. Phillips, et al. (2004)
PNAS 101, 12266-12270
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Classic AIDS in a Sooty Mangabey after an 18-Year Natural Infection.
B. Ling, C. Apetrei, I. Pandrea, R. S. Veazey, A. A. Lackner, B. Gormus, and P. A. Marx (2004)
J. Virol. 78, 8902-8908
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Enhanced cellular immunity and systemic control of SHIV infection by combined parenteral and mucosal administration of a DNA prime MVA boost vaccine regimen.
B. Makitalo, P. Lundholm, J. Hinkula, C. Nilsson, K. Karlen, A. Morner, G. Sutter, V. Erfle, J. L. Heeney, B. Wahren, et al. (2004)
J. Gen. Virol. 85, 2407-2419
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Mapping Sites of Positive Selection and Amino Acid Diversification in the HIV Genome: An Alternative Approach to Vaccine Design?.
T. de Oliveira, M. Salemi, M. Gordon, A.-M. Vandamme, E. J. van Rensburg, S. Engelbrecht, H. M. Coovadia, and S. Cassol (2004)
Genetics 167, 1047-1058
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A Human Immunodeficiency Virus Type 1-Infected Individual with Low Viral Load Harbors a Virus Variant That Exhibits an In Vitro RNA Dimerization Defect.
H. Huthoff, A. T. Das, M. Vink, B. Klaver, F. Zorgdrager, M. Cornelissen, and B. Berkhout (2004)
J. Virol. 78, 4907-4913
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Immune Selection for Altered Antigen Processing Leads to Cytotoxic T Lymphocyte Escape in Chronic HIV-1 Infection.
R. Draenert, S. Le Gall, K. J. Pfafferott, A. J. Leslie, P. Chetty, C. Brander, E. C. Holmes, S.-C. Chang, M. E. Feeney, M. M. Addo, et al. (2004)
J. Exp. Med. 199, 905-915
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Correlation between env V1/V2 Region Diversification and Neutralizing Antibodies during Primary Infection by Simian Immunodeficiency Virus sm in Rhesus Macaques.
B. J. Rybarczyk, D. Montefiori, P. R. Johnson, A. West, R. E. Johnston, and R. Swanstrom (2004)
J. Virol. 78, 3561-3571
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Frequent Simian Foamy Virus Infection in Persons Occupationally Exposed to Nonhuman Primates.
W. M. Switzer, V. Bhullar, V. Shanmugam, M.-e. Cong, B. Parekh, N. W. Lerche, J. L. Yee, J. J. Ely, R. Boneva, L. E. Chapman, et al. (2004)
J. Virol. 78, 2780-2789
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Leishmania infantum Promotes Replication of HIV Type 1 in Human Lymphoid Tissue Cultured Ex Vivo by Inducing Secretion of the Proinflammatory Cytokines TNF-{alpha} and IL-1{alpha}.
C. Zhao, B. Papadopoulou, and M. J. Tremblay (2004)
J. Immunol. 172, 3086-3093
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Mycobacterium tuberculosis Recall Antigens Suppress HIV-1 Replication in Anergic Donor Cells via CD8+ T Cell Expansion and Increased IL-10 Levels.
S. Ranjbar, N. Ly, S. Thim, J.-M. Reynes, and A. E. Goldfeld (2004)
J. Immunol. 172, 1953-1959
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Persistent Recognition of Autologous Virus by High-Avidity CD8 T Cells in Chronic, Progressive Human Immunodeficiency Virus Type 1 Infection.
R. Draenert, C. L. Verrill, Y. Tang, T. M. Allen, A. G. Wurcel, M. Boczanowski, A. Lechner, A. Y. Kim, T. Suscovich, N. V. Brown, et al. (2004)
J. Virol. 78, 630-641
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Immune Failure in the Absence of Profound CD4+ T-Lymphocyte Depletion in Simian Immunodeficiency Virus-Infected Rapid Progressor Macaques.
V. M. Hirsch, S. Santra, S. Goldstein, R. Plishka, A. Buckler-White, A. Seth, I. Ourmanov, C. R. Brown, R. Engle, D. Montefiori, et al. (2004)
J. Virol. 78, 275-284
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Human Immunodeficiency Virus Type 1 Fitness Is a Determining Factor in Viral Rebound and Set Point in Chronic Infection.
A. Trkola, H. Kuster, C. Leemann, C. Ruprecht, B. Joos, A. Telenti, B. Hirschel, R. Weber, S. Bonhoeffer, and H. F. Gunthard (2003)
J. Virol. 77, 13146-13155
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Identification of Sequential Viral Escape Mutants Associated with Altered T-Cell Responses in a Human Immunodeficiency Virus Type 1-Infected Individual.
M. J. Geels, M. Cornelissen, H. Schuitemaker, K. Anderson, D. Kwa, J. Maas, J. T. Dekker, E. Baan, F. Zorgdrager, R. van den Burg, et al. (2003)
J. Virol. 77, 12430-12440
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