Quick Search:

uzh logo
Browse by:

Zurich Open Repository and Archive

Maintenance: Tuesday, July the 26th 2016, 07:00-10:00

ZORA's new graphical user interface will be relaunched (For further infos watch out slideshow ZORA: Neues Look & Feel). There will be short interrupts on ZORA Service between 07:00am and 10:00 am. Please be patient.

Herbeck, J T; Müller, V; Maust, B S; Ledergerber, B; Torti, C; Di Giambenedetto, S; Gras, L; Günthard, H F; Jacobson, L P; Mullins, J I; Gottlieb, G S (2012). Is the virulence of HIV changing? A meta-analysis of trends in prognostic markers of HIV disease progression and transmission. AIDS, 26(2):193-205.

Full text not available from this repository.

View at publisher


OBJECTIVE:: The potential for changing HIV-1 virulence has significant implications for the AIDS epidemic, including changing HIV transmission rates, rapidity of disease progression, and timing of ART. Published data to date have provided conflicting results. DESIGN:: We conducted a meta-analysis of changes in baseline CD4 T-cell counts and set point plasma viral RNA load over time in order to establish whether summary trends are consistent with changing HIV-1 virulence. METHODS:: We searched PubMed for studies of trends in HIV-1 prognostic markers of disease progression and supplemented findings with publications referenced in epidemiological or virulence studies. We identified 12 studies of trends in baseline CD4 T-cell counts (21 052 total individuals), and eight studies of trends in set point viral loads (10 785 total individuals), spanning the years 1984-2010. Using random-effects meta-analysis, we estimated summary effect sizes for trends in HIV-1 plasma viral loads and CD4 T-cell counts. RESULTS:: Baseline CD4 T-cell counts showed a summary trend of decreasing cell counts [effect = -4.93 cells/μl per year, 95% confidence interval (CI) -6.53 to -3.3]. Set point viral loads showed a summary trend of increasing plasma viral RNA loads (effect = 0.013 log10 copies/ml per year, 95% CI -0.001 to 0.03). The trend rates decelerated in recent years for both prognostic markers. CONCLUSION:: Our results are consistent with increased virulence of HIV-1 over the course of the epidemic. Extrapolating over the 30 years since the first description of AIDS, this represents a CD4 T cells loss of approximately 148 cells/μl and a gain of 0.39 log10 copies/ml of viral RNA measured during early infection. These effect sizes would predict increasing rates of disease progression, and need for ART as well as increasing transmission risk.


36 citations in Web of Science®
35 citations in Scopus®
Google Scholar™


Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Deposited On:29 Mar 2012 06:51
Last Modified:05 Apr 2016 15:22
Publisher:Lippincott Wiliams & Wilkins
Publisher DOI:10.1097/QAD.0b013e32834db418
PubMed ID:22089381

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page