Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |19 September 2000

Cell Count, Viral Load, and Clinical Outcome in Patients with HIV Infection after Highly Active Antiretroviral Therapy

  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
  • FULL ARTICLE
    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
    • What did the researchers find?
    • What were the limitations of the study?
    • What are the implications of the study?
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link
  • CiteULike Link

What is the problem and what is known about it so far?

A combination of powerful anti-HIV drugs known as highly active antiretroviral therapy (HAART) can prevent AIDS-related complications in persons with HIV infection. Two laboratory tests, CD4 cell count and viral load, are used to monitor patients' response to HAART. CD4 count is a measure of immune cells; high CD4 counts are better than low ones. The viral load test directly measures the amount of the virus in a person's blood; the lower the viral load, the better. It is not known which test is better at predicting how well patients will do while receiving this therapy.

Why did the researchers do this particular study?

To better understand the relationship among CD4 count, viral load, and clinical outcomes for persons taking HAART.

Who was studied?

The study included 2236 HIV-infected patients from 68 hospitals in France. To be in the study, patients had to be starting HAART for the first time.

How was the study done?

After patients had been receiving HAART for 6 months, the researchers measured CD4 counts and viral loads, which allowed them to classify patients into four categories: 1) complete responders [both CD4 count and viral load improved], 2) immune responders [CD4 count improved but viral load did not], 3) virologic responders [viral load improved but CD4 count did not], and 4) nonresponders (neither CD4 count nor viral load improved). The researchers then followed patients to see who died or developed an AIDS-related complication.

What did the researchers find?

After an average follow-up of 18 months, 69 patients had died and 123 had experienced a new AIDS-related complication. After accounting for other factors that might be related to poor outcomes, complete responders were the least likely and nonresponders were the most likely to die or have a complication. Patients in whom CD4 count improved but viral load did not (immune responders) fared second best, followed by those in whom viral load improved but CD4 count did not (virologic responders).

What were the limitations of the study?

This study did not include patients who died or were lost to follow-up during the first 6 months, so it may have underestimated the risk for poor outcomes. The researchers considered a viral load improved even if virus levels decreased but were still detectable; some researchers would consider only an undetectable virus level to be a virologic response. The study had limited ability to examine the effect of previous treatment with anti-HIV drugs, which can influence how patients respond to HAART.

What are the implications of the study?

Both CD4 count and viral load are useful in monitoring HIV-infected persons taking HAART, but CD4 count seems to be somewhat more important.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.

The summary below is from the full report titled “Clinical Outcome of Patients with HIV-1 Infection according to Immunologic and Virologic Response after 6 Months of Highly Active Antiretroviral Therapy.” It is in the 19 September 2000 issue of Annals of Internal Medicine (volume 133, pages 401-410). The authors are S Grabar, V Le Moing, C Goujard, C Leport, MD Kazatchkine, D Costagliola, and L Weiss.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.
The summary below is from the full report titled “Clinical Outcome of Patients with HIV-1 Infection according to Immunologic and Virologic Response after 6 Months of Highly Active Antiretroviral Therapy.” It is in the 19 September 2000 issue of Annals of Internal Medicine (volume 133, pages 401-410). The authors are S Grabar, V Le Moing, C Goujard, C Leport, MD Kazatchkine, D Costagliola, and L Weiss.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Cell Count, Viral Load, and Clinical Outcome in Patients with HIV Infection after Highly Active Antiretroviral Therapy. Ann Intern Med. ;133:I–16. doi: 10.7326/0003-4819-133-6-200009190-00001

Download citation file:

  • Ris (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2019

×
Permissions

Published: Ann Intern Med. 2000;133(6):I-16.

DOI: 10.7326/0003-4819-133-6-200009190-00001

0 Citations

See Also

Clinical Outcome of Patients with HIV-1 Infection according to Immunologic and Virologic Response after 6 Months of Highly Active Antiretroviral Therapy
View MoreView Less

Related Articles

Guidelines for Using Antiretroviral Agents among HIV-Infected Adults and Adolescents: The Panel on Clinical Practices for Treatment of HIV*
Annals of Internal Medicine; 137 (5_Part_2): 381-433
Factors Associated With Lack of Viral Suppression at Delivery Among Highly Active Antiretroviral Therapy–Naive Women With HIV: A Cohort Study
Annals of Internal Medicine; 162 (2): 90-99
Hepatic Decompensation in Antiretroviral-Treated Patients Co-Infected With HIV and Hepatitis C Virus Compared With Hepatitis C Virus–Monoinfected Patients: A Cohort Study
Annals of Internal Medicine; 160 (6): 369-379
U.S. Trends in Antiretroviral Therapy Use, HIV RNA Plasma Viral Loads, and CD4 T-Lymphocyte Cell Counts Among HIV-Infected Persons, 2000 to 2008
Annals of Internal Medicine; 157 (5): 325-335
View MoreView Less

Journal Club

The Xpert HCV Viral Load Finger-Stick point-of-care test was accurate for detecting HCV RNA
Annals of Internal Medicine; 169 (6): JC35
TDF-FTC before and after sex reduced HIV infection but increased GI, renal events in men who have sex with men
Annals of Internal Medicine; 164 (6): JC28
Preexposure tenofovir–emtricitabine reduced HIV infection in men who have unprotected anal sex with men
Annals of Internal Medicine; 164 (2): JC3
In early HIV infection, immediate vs deferred antiretroviral therapy reduced serious illnesses at 3 years
Annals of Internal Medicine; 163 (12): JC4
View MoreView Less

Related Point of Care

Management of Newly Diagnosed HIV Infection
Annals of Internal Medicine; 167 (1): ITC1-ITC16
Management of Newly Diagnosed HIV Infection
Annals of Internal Medicine; 155 (7): ITC4-1
View MoreView Less

Related Topics

HIV
Infectious Disease

HIV, Infectious Disease.

PubMed Articles

BM-MSCs-derived ECM modifies multiple myeloma phenotype and drug response in a source-dependent manner.
Transl Res 2019.
A dynamic network model to disentangle the roles of steady and casual partners for HIV transmission among MSM.
Epidemics 2019.
View More

Results provided by: PubMed

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Latest RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards and Cover

  • Personae (Cover Photo)
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×