Related Experiment Videos
Sex differences in HIV-1 viral load and progression to AIDS
H Farzadegan1, D R Hoover, J Astemborski
1Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA. hfarzade@jhsph.edu
Lancet (London, England)
|November 20, 1998
Summary
Women with HIV have lower viral loads than men, but a higher risk of AIDS at similar viral loads. These findings suggest revised HIV-1 viral load guidelines for women are needed.
Area of Science:
- Immunology
- Virology
- Epidemiology
Background:
- Plasma HIV-1 RNA measurements guide antiretroviral therapy initiation.
- The association between viral load and prognosis in women versus men is not well understood.
Purpose of the Study:
- To investigate sex-based differences in HIV-1 viral load measurements.
- To determine if the association between viral load and AIDS prognosis differs between men and women.
Main Methods:
- Analysis of 812 specimens from 650 HIV-1-infected injection drug users (IDUs).
- HIV-1 viral load measured by branched-chain DNA, reverse-transcriptase PCR, and quantitative microculture.
- Proportional-hazards models used to assess time to AIDS, adjusting for CD4 cell count, race, and recent drug use.
Main Results:
- Women consistently showed lower median HIV-1 viral loads than men across all measurement methods.
- This sex-based difference in viral load persisted after adjusting for covariates.
- Time to AIDS was similar for men and women in adjusted models, but women with the same viral load as men had a significantly higher risk of developing AIDS.
Conclusions:
- Despite lower viral loads, women with HIV face a disproportionately higher risk of AIDS progression compared to men.
- These findings indicate a potential need to lower HIV-1 viral load thresholds for initiating antiretroviral therapy in women.