Impact of HIV type 1 DNA levels on spontaneous disease progression: a meta-analysis

AIDS Res Hum Retroviruses. 2012 Apr;28(4):366-73. doi: 10.1089/aid.2011.0032. Epub 2011 Aug 30.

Abstract

Several studies have reported the prognostic strength of HIV-1 DNA with variable results however. The aims of the current study were to estimate more accurately the ability of HIV-1 DNA to predict progression of HIV-1 disease toward acquired immunodeficiency syndrome (AIDS) or death, and to compare the prognostic information obtained by HIV-1 DNA with that derived from plasma HIV-1 RNA. Eligible articles were identified through a comprehensive search of Medline, ISI Web of Science, Scopus, and Google Scholar. The analysis included univariate and bivariate random-effects models. The univariate meta-analysis of six studies involving 1074 participants showed that HIV-1 DNA was a strong predictive marker of AIDS [relative risk (RR): 3.01, 95% confidence interval (CI): 1.88-4.82] and of all-cause mortality (RR: 3.49, 95% CI: 2.06-5.89). The bivariate model using the crude estimates of primary studies indicated that HIV-1 DNA was a significantly better predictor than HIV-1 RNA of either AIDS alone (ratio of RRs=1.47, 95% CI: 1.05-2.07) or of combined (AIDS or death) progression outcomes (ratio of RRs=1.51, 95% CI: 1.11-2.05). HIV-1 DNA is a strong predictor of HIV-1 disease progression. Moreover, there is some evidence that HIV-1 DNA might have better predictive value than plasma HIV-1 RNA.

Publication types

  • Meta-Analysis

MeSH terms

  • Acquired Immunodeficiency Syndrome / blood
  • Acquired Immunodeficiency Syndrome / virology*
  • Biomarkers / blood
  • DNA, Viral / blood*
  • Disease Progression
  • Female
  • HIV-1 / genetics*
  • Humans
  • Male
  • Predictive Value of Tests
  • Prognosis
  • RNA, Viral / blood*
  • Viral Load* / genetics

Substances

  • Biomarkers
  • DNA, Viral
  • RNA, Viral