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AJPH First Look, published online ahead of print Feb 12, 2009
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AJPH.2008.137901v1
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April 2009, Vol 99, No. S1 | American Journal of Public Health S193-S196
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.137901

RESEARCH AND PRACTICE

Association Between HIV-1 RNA Level and CD4 Cell Count Among Untreated HIV-Infected Individuals

Viviane D. Lima, PhD, Valeria Fink, MD, Benita Yip, BSc (Pharm), Robert S. Hogg, PhD, P. Richard Harrigan, PhD and Julio S. G. Montaner, MD

Viviane D. Lima, Benita Yip, Robert S. Hogg, P. Richard Harrigan, and Julio S. G. Montaner are with the British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia. Viviane D. Lima, P. Richard Harrigan, and Julio S. G. Montaner are also with the Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver. Robert S. Hogg is also with the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia. Valeria Fink is with Servicio de Infectología [Infection Clinic], Hospital Fernandez, Buenos Aires, Argentina.

Correspondence: Requests for reprints should be sent to Julio S. G. Montaner, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, 667-1081 Burrard St, Vancouver, BC, V6Z 1Y6 Canada (e-mail: jmontaner{at}cfenet.ubc.ca).

Objectives. We examined the significance of plasma HIV-1 RNA levels (or viral load alone) in predicting CD4 cell decline in untreated HIV-infected individuals.

Methods. Data were obtained from the British Columbia Centre for Excellence in HIV/AIDS. Participants included all residents who ever had a viral load determination in the province and who had never taken antiretroviral drugs (N = 890). We analyzed a total of 2074 viral load measurements and 2332 CD4 cell counts. Linear mixed-effects models were used to predict CD4 cell decline over time.

Results. Longitudinal viral load was strongly associated with CD4 cell decline over time; an average of 1 log10 increase in viral load was associated with a 55-cell/mm3 decrease in CD4 cell count.

Conclusions. Our results support the combined use of CD4 cell count and viral load as prognostic markers in HIV-infected individuals before the introduction of antiretroviral therapy.






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