|| Checking for direct PDF access through Ovid
To examine whether the levels of plasma RNA and DNA provirus predict the rate of CD4 cell decline and patient death.Retrospective analysis of HIV-2 cohort subjects.Fifty-two subjects were recruited between January 1991 and December 1992. HIV-2 RNA levels in plasma and DNA levels in peripheral blood mononuclear cells (PBMC) were measured using in-house quantitative PCR assays. The annual rate of CD4 cell decline was calculated using the least-squares method. The survival data on 31 December 1997 were used.The mean percentage of CD4 cells at baseline was 30.7 (SD, 9.5). In a linear regression model, the annual rate of CD4 cell decline was 1.76 CD4% faster for every increase in one log10 RNA copies/ml [95% confidence interval (CI), 0.81–2.7;P = 0.0006;r = 0.46; n = 52] and 1.76 CD4% faster for every increase in log10 DNA copies/105 PBMC (95% CI 0.46–3.1;P = 0.01;r = 0.33; n = 42). In a multiple linear regression model, RNA load was related to CD4 decline independently of DNA load (P = 0.02). The overall mortality rate was 7.29/100 person-years. In a Cox regression model, the hazard rate increased by 2.12 for each log10 increase in RNA load (95% CI, 1.3–3.5;P = 0.0023) but only by 1.09 for each log10 increase in DNA load (95% CI, 0.64–1.87;P = 0.8).This longitudinal study shows for the first time that a baseline HIV-2 RNA load predicts the rate of disease progression. HIV-2-infected patients with a high viral load may need to be treated as vigorously as HIV-1 patients.