AIDSWEEKLY Plus; Monday, December 14, 1998
Daniel J. DeNoon, Senior Editor
The new data show that women with HIV infection have lower viral load measurements than men. This would appear to be good news: but the data also shows that women develop AIDS as quickly as men.
These findings remain statistically significant even when adjusted for CD4 cell count, race, and recent drug use.
"Proportional-hazards models show that women with the same viral load as men had a 1.6-fold higher risk of AIDS (95% CI 1.1-2.32); or, equivalently, that women with half the viral load of men had a similar time to AIDS as men," wrote Johns Hopkins researcher Homayoon Farzadegan and colleagues.
The researchers reported their findings in the journal The Lancet ("Sex Differences in HIV-1 Viral Load and Progression to AIDS," Lancet, 1998;352:1510-4).
Farzadegan et al. analyzed 812 blood specimens obtained from 650 injection-drug users in an ongoing, observational study of community- clinic-based patients. They measured HIV loads by branched-chain DNA (bDNA) tests, reverse-transcriptase polymerase chain reaction (PCR) assays, and quantitative microculture.
When women were compared to men, their median virus load was 3365 vs. 8907 copies/mL by bDNA (P=0.001); 45,416 vs. 93,130 copies/mL by PCR (P=0.02); and 5 vs. 8 infectious units per million peripheral blood cells by quantitative microculture (P=0.015).
Farzadegan et al. noted that current U.S. Public Health Service (PHS) guidelines recommend beginning antiretroviral therapy for patients with viral loads of 10,000 copies/mL when CD4 counts are >=500 cells/(micro)L. These guidelines, however, were developed on data collected in studies of men.
"A downward revision of the viral-load threshold for women by as much as half (5000 copies/mL) might be prudent," they warned. "The possibility that women according to current guidelines - will be undertreated on a population level must be carefully considered."
The authors warned that their findings should not be interpreted to mean that women have a shorter time to AIDS after HIV infection. They instead stress the interpretation that the relationship between viral load and AIDS is different for men and women.
Exactly why the observed phenomenon occurs is unexplained.
This study was primarily supported by a grant from the National Institute on Drug Abuse, with additional funding provided by the U.S. Centers for Disease Control and Prevention (CDC).
The corresponding author for this study is Homayoon Farzadegan, Johns Hopkins School of Hygiene and Public Health, 615 N. Wolfe Street, Room E6004, Baltimore, Maryland 21205. Email: <hfarzade@jhsph.edu>.
981214
AW981208
Copyright © 1998 - Charles Henderson, Publisher. All rights Reserved. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA.
Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633-4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX: (205) 995-1588 http://www.newsfile.com
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 1998. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 1998. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .