Roy M. Gulick, MD, MPH
Gulick RM. Assessing the Benefits of Antiretroviral Therapy. Ann Intern Med. 2000;133:471-473. doi: 10.7326/0003-4819-133-6-200009190-00016
Download citation file:
Published: Ann Intern Med. 2000;133(6):471-473.
Originally, CD4 lymphocyte count was the best available marker for assessing the prognosis of the HIV-infected patient (1). After assays to measure HIV RNA were developed, viral load was initially thought to be a better predictor of clinical progression (2). Later, in a much larger patient cohort, Mellors and coworkers (3) found that prognosis could best be predicted by looking at both viral load and CD4 cell count. Coffin (4) first used a powerful analogy to describe the different prognostic information provided by viral load and CD4 cell count: If HIV infection is a train traveling down a track and the development of AIDS is a damaged bridge ahead, the viral load is how fast the train is going and the CD4 cell count is the distance to the bridge. Pathogenetically, this makes sense: Viral load reflects the amount of viral replication occurring in an infected person, and ongoing viral replication results in CD4 cell depletion and immune compromise. In practice, viral load, CD4 cell count, and clinical status together provide important information that can be used to assess the HIV-infected patient.
Learn more about subscription options.
Register Now for a free account.
Infectious Disease, HIV.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only