FACTORS PREDICT AIDS IN HIV+ DRUG USERS

NEW YORK (Reuters) -- A study of injection drug users (IDUs) indicates that
plasma levels of HIV, as measured by HIV RNA, can predict risk of
progression to AIDS.

The study published this week in The Journal of the American Medical
Association, also shows that the combination of HIV RNA load and CD4 cell
measurements also provide "...powerful prognostic information for
progression to AIDS and death."

"This study is unique because in contrast to prior studies of this type,
largely involving white homosexual men, this study includes mostly
African-American men and women as well as large numbers of active IDUs,"
according to a report in the journal.

Dr. David Vlahov of Johns Hopkins University in Baltimore and colleagues
followed 522 HIV-positive IDUs residing in the local Baltimore community.
Most were African-American (96%) and reported using injection drugs within
the last six months (96%). None of the subjects had been previously treated
with combination antiretroviral therapy.

Over an average follow-up of about six years, 146 subjects developed AIDS
and 119 patients died. The researchers then compared the patients' initial
HIV RNA and CD4+ levels with the length of time it took to develop AIDS and
time to death from infectious disease.

Their results confirm that, as reported in other patient subgroups such as
the Multicenter AIDS Cohort Study, which is composed primarily of upper
middle-class white homosexual men, plasma HIV RNA and CD4+ cell levels
independently predicted disease outcome.

The researchers believe that "...an important finding is that the same
basic relationship between virologic and immunologic factors applies in
African-American IDUs as in nonminority persons from other risk groups."
Therefore, "...the same level of aggressive therapy should be offered
irrespective of demographic or risk group."

These results complement the report by Dr. Michael Saag and colleagues in
the January issue of the Journal of Infectious Diseases in which they
confirmed the value of using both viral load and CD4+ cell counts to assess
the prognosis of HIV-positive patients and their response to treatment.
SOURCE: The Journal of the American Medical Association (1998;279:35-40)

Copyright 1997 Reuters Limited.