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Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS.

Publication ,  Journal Article
Blattner, WA; Oursler, KA; Cleghorn, F; Charurat, M; Sill, A; Bartholomew, C; Jack, N; O'Brien, T; Edwards, J; Tomaras, G; Weinhold, K; Greenberg, M
Published in: J Infect Dis
May 15, 2004

OBJECTIVE: Our objective was to define early virologic and immunologic determinants of human immunodeficiency virus (HIV) type 1 disease progression among 22 case subjects with acute infection from the Trinidad Seroconvertor Cohort. METHODS: A linear segmented regression model was fitted to sequential quantitative virus load measurements. Parameters of virus kinetics during different phases of primary infection were correlated with clinical and immunologic end points, by use of Kaplan-Meier estimates and Cox regression. RESULTS: Ten individuals developed acquired immunodeficiency syndrome (AIDS)-defining events. In univariate analysis, progression to AIDS was associated with rate of initial HIV clearance (P=.002), virus load during set point (P=.008), and CD4(+) cell count during steady state (P=.04). In the multivariate analysis, a rapid rate of initial clearance was the sole independent predictor of subsequent progression to AIDS and was associated with a 92% reduction in the risk of AIDS. The rate of initial clearance is inversely correlated with the number of early symptoms (r=-0.66; P=.0008). However, symptoms did not predict subsequent risk of AIDS. CONCLUSION: Among a subset of patients, rapid clearance of plasma HIV-1 after peak viremia is associated with lower viral set point, prolonged virus suppression before loss of virologic control, and decreased risk of AIDS. These findings are consistent with the hypothesis that effective immune responses during the earliest phase of infection are important determinants of the subsequent natural history.

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Published In

J Infect Dis

DOI

ISSN

0022-1899

Publication Date

May 15, 2004

Volume

189

Issue

10

Start / End Page

1793 / 1801

Location

United States

Related Subject Headings

  • Reverse Transcriptase Polymerase Chain Reaction
  • RNA, Viral
  • Prospective Studies
  • Proportional Hazards Models
  • Microbiology
  • Male
  • Longitudinal Studies
  • Kinetics
  • Humans
  • HIV-1
 

Citation

APA
Chicago
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MLA
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Blattner, W. A., Oursler, K. A., Cleghorn, F., Charurat, M., Sill, A., Bartholomew, C., … Greenberg, M. (2004). Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS. J Infect Dis, 189(10), 1793–1801. https://doi.org/10.1086/386306
Blattner, William A., Kris Ann Oursler, Farley Cleghorn, Manhattan Charurat, Anne Sill, Courtenay Bartholomew, Noreen Jack, et al. “Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS.J Infect Dis 189, no. 10 (May 15, 2004): 1793–1801. https://doi.org/10.1086/386306.
Blattner WA, Oursler KA, Cleghorn F, Charurat M, Sill A, Bartholomew C, et al. Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS. J Infect Dis. 2004 May 15;189(10):1793–801.
Blattner, William A., et al. “Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS.J Infect Dis, vol. 189, no. 10, May 2004, pp. 1793–801. Pubmed, doi:10.1086/386306.
Blattner WA, Oursler KA, Cleghorn F, Charurat M, Sill A, Bartholomew C, Jack N, O’Brien T, Edwards J, Tomaras G, Weinhold K, Greenberg M. Rapid clearance of virus after acute HIV-1 infection: correlates of risk of AIDS. J Infect Dis. 2004 May 15;189(10):1793–1801.
Journal cover image

Published In

J Infect Dis

DOI

ISSN

0022-1899

Publication Date

May 15, 2004

Volume

189

Issue

10

Start / End Page

1793 / 1801

Location

United States

Related Subject Headings

  • Reverse Transcriptase Polymerase Chain Reaction
  • RNA, Viral
  • Prospective Studies
  • Proportional Hazards Models
  • Microbiology
  • Male
  • Longitudinal Studies
  • Kinetics
  • Humans
  • HIV-1