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Predictive value of HIV-1 RNA detection in plasma by branched DNA assay during long-term zidovudine therapy

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Abstract

The predictive value of human immunodeficiency virus type 1 (HIV-1) RNA detection in plasma using branched DNA assay was studied in a subgroup of 36 asymptomatic HIV-1-infected patients enrolled in a multicenter, double-blind, randomized study. Patients were randomized to receive either zidovudine (AZT) 1 g/day or placebo and were monitored for a mean time of 61 months. HIV-1 RNA was detected in plasma using branched DNA assay at months 0, 6, 12, 24, and 36. HIV-1 RNA was detected at levels of ≥ 104 RNA eq/ml (eq/ml) in 8.3% of the patients at baseline, and this percentage increased during the first two years in the placebo group only. The detection rate of HIV-1 RNA at three years was 50% in both the AZT and the placebo groups. HIV-1 RNA levels ranged from 104 to 478 × 103 RNA eq/ml. HIV-1 RNA was detected at levels of > 104 eq/ml a mean time of 19±13 months before progression to AIDS in 76.5% of progressing patients. In a multivariate analysis including baseline CD4+ count, the initial randomization group, HIV-1 RNA detection in plasma, and detection of p24 antigenemia during the first three years of follow-up, the best independent predictors of progression to AIDS at five years and the best independent predictors of death at five years were HIV-1 RNA detection in plasma and p24 antigenemia.

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Authors and Affiliations

  1. Service d'Hépatogastroentérologie et de SIDA, Hotel-Dieu, 1 place de l'Hopital, 69288, Lyon, France

    L. Cotte, P. Rougier, F. Bailly & C. Trepo

  2. Institut National de la Santé et de la Recherche Médicale, Unité 271, 151 Cours A. Thomas, 69003, Lyon, France

    M. A. Trabaud & C. Trepo

  3. Centre d'Informatique Médicale, Hℸel-Dieu, 1 place de l'Hopital, 69288, Lyon, France

    F. Chapuis

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  1. L. Cotte
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  2. M. A. Trabaud
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  3. P. Rougier
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  4. F. Bailly
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  5. F. Chapuis
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  6. C. Trepo
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Cotte, L., Trabaud, M.A., Rougier, P. et al. Predictive value of HIV-1 RNA detection in plasma by branched DNA assay during long-term zidovudine therapy. Eur. J. Clin. Microbiol. Infect. Dis. 15, 639–645 (1996). https://doi.org/10.1007/BF01691149

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