AIDS; new developments. III. Predictive value of the quantity of HIV-RNA for the course of the HIV infection and the effect of the treatment
Standardized tests to measure the quantity of HIV-RNA in blood have been available since early 1995. Individual differences in quantity of HIV-RNA in blood are determined mainly by differences in virus production. Most of the HIV production takes place in infected and activated CD4+ T lymphocytes. The concentration of HIV-RNA in plasma or serum is an important predictor of AIDS and death, in the early stage of the infection even the only one. High concentrations (> or = 10(4) HIV-RNA copies/ml) in the early stage of the infection increase the probability of AIDS from 2.5 to 5 times that with concentrations < 10(4) HIV-RNA copies/ml. The degree of reduction of the HIV-RNA concentration during anti-HIV therapy is of great predictive value for the clinical course. The percentage of persons in whom the amount of HIV-RNA decreases to below the limit of detectability is a good second indicator of a favourable prognosis. Consequently, anti-HIV treatment should be started as early as possible in the infection, and not postponed until the first symptoms of immunodeficiency occur; only then can the virus production be kept at a minimal level as early and as long as possible. The current guideline reads: determination of HIV-RNA concentrations in serum or plasma should be part of the standard clinical practice in monitoring HIV-infected persons. Treatment is started as soon as occasioned by the quantity of HIV-RNA (limit: 10,000 copies/ml), the CD4+ cell count (limit: 500 x 10(6)/l) or the onset of HIV-related symptoms. The quantity of HIV-RNA should diminish substantially during the first three months of treatment. If this is the case, one checkup every three months will suffice. If the HIV-RNA concentration does not decrease sufficiently, resistance or poor compliance may be involved.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
1997 |
|---|---|
| Erschienen: |
1997 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:141 |
|---|---|
| Enthalten in: |
Nederlands tijdschrift voor geneeskunde - 141(1997), 21 vom: 24. Mai, Seite 1043-50 |
| Sprache: |
Niederländisch |
|---|
| Weiterer Titel: |
AIDS; nieuwe ontwikkelingen. III. Voorspellende waarde van de hoeveelheid HIV-RNA voor het beloop van de HIV-infective en het effect van de behandeling |
|---|
| Beteiligte Personen: |
de Wolf, F [VerfasserIn] |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 21.10.1997 Date Revised 15.11.2006 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM092861997 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM092861997 | ||
| 003 | DE-627 | ||
| 005 | 20231222091948.0 | ||
| 007 | tu | ||
| 008 | 231222s1997 xx ||||| 00| ||dut c | ||
| 028 | 5 | 2 | |a pubmed24n0310.xml |
| 035 | |a (DE-627)NLM092861997 | ||
| 035 | |a (NLM)9340561 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a dut | ||
| 100 | 1 | |a de Wolf, F |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a AIDS; new developments. III. Predictive value of the quantity of HIV-RNA for the course of the HIV infection and the effect of the treatment |
| 246 | 3 | 3 | |a AIDS; nieuwe ontwikkelingen. III. Voorspellende waarde van de hoeveelheid HIV-RNA voor het beloop van de HIV-infective en het effect van de behandeling |
| 264 | 1 | |c 1997 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 21.10.1997 | ||
| 500 | |a Date Revised 15.11.2006 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Standardized tests to measure the quantity of HIV-RNA in blood have been available since early 1995. Individual differences in quantity of HIV-RNA in blood are determined mainly by differences in virus production. Most of the HIV production takes place in infected and activated CD4+ T lymphocytes. The concentration of HIV-RNA in plasma or serum is an important predictor of AIDS and death, in the early stage of the infection even the only one. High concentrations (> or = 10(4) HIV-RNA copies/ml) in the early stage of the infection increase the probability of AIDS from 2.5 to 5 times that with concentrations < 10(4) HIV-RNA copies/ml. The degree of reduction of the HIV-RNA concentration during anti-HIV therapy is of great predictive value for the clinical course. The percentage of persons in whom the amount of HIV-RNA decreases to below the limit of detectability is a good second indicator of a favourable prognosis. Consequently, anti-HIV treatment should be started as early as possible in the infection, and not postponed until the first symptoms of immunodeficiency occur; only then can the virus production be kept at a minimal level as early and as long as possible. The current guideline reads: determination of HIV-RNA concentrations in serum or plasma should be part of the standard clinical practice in monitoring HIV-infected persons. Treatment is started as soon as occasioned by the quantity of HIV-RNA (limit: 10,000 copies/ml), the CD4+ cell count (limit: 500 x 10(6)/l) or the onset of HIV-related symptoms. The quantity of HIV-RNA should diminish substantially during the first three months of treatment. If this is the case, one checkup every three months will suffice. If the HIV-RNA concentration does not decrease sufficiently, resistance or poor compliance may be involved | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a RNA, Viral |2 NLM | |
| 700 | 1 | |a Goudsmit, J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Nederlands tijdschrift voor geneeskunde |d 1946 |g 141(1997), 21 vom: 24. Mai, Seite 1043-50 |w (DE-627)NLM000034231 |x 1876-8784 |7 nnns |
| 773 | 1 | 8 | |g volume:141 |g year:1997 |g number:21 |g day:24 |g month:05 |g pages:1043-50 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 141 |j 1997 |e 21 |b 24 |c 05 |h 1043-50 | ||