The amount of virus in HIV patients is a better predictor of diseaseprogression and survival than CD4 T cell counts, according to thelargest outcome analysis of viral load to date.
That conclusion was reached by a professor at the University ofPittsburgh Medical Center who presented his findings recently at theThird Conference of Retroviruses and Opportunistic Infections inWashington.
John Mellors, associate professor of medicine at the university, usinga branch DNA assay developed by Chiron Diagnostics, collectedsamples every six months for 10 years from 181 HIV-infectedpeople.
Mellors found the risk of progression to AIDS after seven years wasless than 10 percent among those with HIV RNA levels in the lowestquartile. Sixty percent of those whose viral load was in the highestquartile progressed to AIDS.
Also, none of the 43 patients in the lowest quartile died within fiveyears while 65 percent (28/43) in the highest quartile died in thatperiod.
"The bDNA technology provides us with a tool to accurately stageHIV disease progression as we can stage many cancers, and fromwhich we can rationally develop treatment strategies," Mellors said."And since the individuals in this study were at various diseasestages, it follows that HIV RNA measurements are very muchpredictive of the consequences of HIV infection in the real world."
Chiron, of Emeryville, Calif., has been offering the assay for severalyears for research use only. The company plans within the next fewweeks to file for regulatory approval of the product, the HIV RNAbDNA Probe Assay, said Kimberly Kraemer, Chiron's manager,corporate communications.
Last year Chiron processed more than 20,000 samples through itsreference laboratory, she said, adding that FDA approval wouldexpand the availability to all laboratories. n
-- Jim Shrine
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