Mathematical modeling of the interrelationship of CD4 lymphocyte count and viral load changes induced by the protease inhibitor indinavir.

Antimicrobial Agents and Chemotherapy
G Drusano, D Stein

Abstract

While CD4 cell counts are widely used to predict disease progression in human immunodeficiency virus (HIV)-infected patients, they are poorly explanatory of the progression to AIDS or death after the introduction of chemotherapy. Changes in HIV load (as measured by RNA PCR) have been shown to be a much better predictor of the risk of disease progression. Since the interrelationship of these markers is of great clinical interest, we modeled the time-averaged return of CD4 cell count and change in viral load subsequent to therapy with the HIV protease inhibitor indinavir. We found that CD4 cell return was significantly related to both the baseline CD4 count (r2 = 0.86, P < 0.001) and the decline in HIV RNA PCR-determined viral load (also referred to in this work as the HIV RNA PCR decline) (r2 = 0.60, P < 0.01). Simultaneously modeling both influences in a linked nonlinear model (r2 = 0.93, P < 0.001) demonstrated that (i) the starting number of CD4 cells accounted for the majority of the change in CD4 cell return and (ii) the return of CD4 cells attributable to viral load decrease was 50% of maximal with only a decrease of approximately 0.2 log of HIV RNA as modeled from the first 12 weeks of therapy. Much greater viral inhibiti...Continue Reading

References

Oct 11, 1990·The New England Journal of Medicine·A C CollierJ M Leedom
Jun 1, 1983·Computer Programs in Biomedicine·M L Rocci, W J Jusko

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Citations

Feb 8, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Richard C WatersJohn A Crump
Jan 1, 2014·Research and Theory for Nursing Practice·Marilou Gagnon, Adrian Guta
Jan 12, 2008·Bioinformatics·Frank M GrazianoGeorge J Towfic

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