Is HIV Becoming More Virulent?

A meta-analysis suggests that over the course of the epidemic, the mean virologic set point of HIV-infected patients has been increasing and the mean baseline CD4-cell count has been decreasing.

Any change in HIV virulence over time could have important implications for transmissibility, disease progression, and timing of treatment initiation. However, studies attempting to assess changes in virulence have yielded discrepant results. To address this issue, investigators conducted a meta-analysis, looking at trends in baseline CD4-cell count and virologic set point over time. Twelve studies, spanning 1984 to 2010 and involving more than 20,000 individuals, were included in the analysis.

Baseline CD4-cell counts appeared to decrease over time (by roughly 5 cells/mm³/year), whereas virologic set points appeared to increase (by 0.013 log copies/mL/year). When the investigators limited their analysis to the nine studies in which all pati…

Reviewing Author

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Is HIV Becoming More Virulent?

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Reviewing Author