Cohort Of HIV-positive Individuals Research Articles

Gender Differences in Virologic Response to Treatment in an HIV-Positive Population: A Cohort Study

Objective: To establish whether a gender difference in virologic response to highly active antiretroviral treatment (HAART) exists. Methods: A cohort of HIV-positive individuals was examined. Outcomes: Achievement of viral load <500 copies/ml and “failure” (failure to suppress viral load <500 copies/ml after 24 weeks or two consecutive measurements above this level after having suppressed below it). Hazard ratios (HRs) comparing the rate in women to that in men were derived using the Cox model. Results: Of 366 male subjects, 79% were white and 82% were homosexual. Sixtythree percent of the 91 female subjects were African and 87% were heterosexual. The median follow-up after HAART was 94 weeks. The baseline CD4 count was higher in men (228 × 106 per liter) than in women (171 × 106 per liter) (p = .01), but the viral load was similar (p = .88). The median time to <500 copies/ml was 16 weeks. Women achieved a viral load of <500 copies/ml at a faster rate than men, with an adjusted HR of 1.46 (95% confidence interval [CI]: 0.99-2.16; p = .06). Some 261 patients failed treatment (58% of men and 53% of women) with an HR of 0.78 (95% CI: 0.51-1.21; p = .27). Conclusions: Women may achieve virologic suppression at a faster rate than men and have a more durable response. Further research should examine these responses in conjunction with clinical outcomes, because gender differences in virologic response may ultimately be of little relevance if clinical outcomes are similar.

Absence of an effect of herpes simplex virus type 2 infection on HIV disease progression: data from a cohort of HIV-positive individuals with known date of seroconversion.

Absence of an effect of herpes simplex virus type 2 infection on HIV disease progression: data from a cohort of HIV-positive individuals with known date of seroconversion.

Cerebrospinal fluid and nerve conduction abnormalities in HIV positive individuals

We studied whether there was an association between nerve conduction studies (NCS), CSF, and CD4-T lymphocyte parameters in a large cohort of HIV positive individuals. Two hundred and twenty-eight HIV positive individuals underwent motor and sensory nerve conduction studies, CSF evaluation, peripheral CD4-T lymphocyte count, and neurologic evaluation to determine the presence or absence of peripheral neuropathy. We compared NCS of HIV positive subjects with and without abnormal CSF parameters in the entire cohort. We also compared CSF parameters in a subset of CD4-matched patients with and without neuropathy. CSF abnormalities (in excess of laboratory norms) occured frequently in the entire study group. There was no statistically significant relationship between NCS and CSF parameters. In addition, there was no significiant difference in the CSF findings in the group of patients with clinical neuropathy compared to the group without neuropathy. However, there was an association ( p < 0.05) between lower CD4 counts and NCS parameters. In general, abnormal CSF findings are not associated with deteriorating peripheral nerve function in HIV infected patients and are just as likely to be found in an HIV positive patient whether or not a peripheral neuropathy is present.