A retrospective record review was made of virologic, immunologic and clinical data obtained over the first year (1996) during which testing for plasma HIV RNA levels was a routine procedure at the University of Texas Hermann Hospital for the purpose of identification of characteristics associated with progressing or regressing infection. At one year after the introduction of HIV RNA testing, patients were classified based on changes in plasma HIV RNA as having increased (progression, P), waning (regression, R) or unchanged (stable, S) levels of infection. Classification as P or R was based on a change of >0.5 log10 HIV RNA copies/ml between first and year-end determinations. Notable findings (Table) included that patients with low levels of entry HIV RNA comprised the majority of progressors, that increased HIV RNA associated with a decline in CD4 and that progressors were less likely to receive treatment with combined antiretrovial drugs or have had their antiretroviral therapy regimen changed during the year.

Table 1 No caption available.
Full size table

The results indicate that physicians were more aggressive in treating patients with impressive HIV RNA levels and that this treatment reduced viral load and stabilized CD4 values. Patients with low viral loads may have benefitted from aggressive early combined antiretroviral therapy.

Table. Classification of patients on changes in HIV RNA over 1 year; HIV RNA is group geometric mean, CD4 is mean percent of lymphocytes and antiretroviral therapy is number of patients receiving no (0), mono (1), double (2) or triple (3) antiretroviral agents; changes, records the number (%) of patients whose antiretroviral therapy was changed during the year.