Abstract
Little evidence exists on how to efficiently and effectively monitor HIV-disease progression in developing countries. Better understanding regarding cost-effective tests may help to resolve questions regarding treatment. A prospective cohort study was conducted with a 1-year follow-up period. Immune complex-dissociated (ICD) p24 antigen (ICD p24Ag), alone or in combination with HIV p24 antibody (p24Ab), was compared to HIV-RNA and CD4+ count in a cohort of 160 HIV-infected adolescents in Romania. The main outcome measure was disease progression, defined as >50,000 copies/ml of HIV-RNA or death. Among the 160 adolescents, a higher mean ICD p24Ag was significantly associated with clinical disease classification (CDC), plasma HIV-RNA concentration, and p24Ab. Multivariate logistic regression showed detectable ICD p24Ag had an odds ratio of 3.7 (95% CI 1.4-9.7) for disease progression in comparison to undetectable ICD p24Ag. ICD p24Ag is of value in determining the prognosis of disease in HIV-1-infected adolescents in developing countries. Additional studies for validation of this assay for HIV clades primarily affecting developing countries, are now needed.
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