HIV has become more virulent over time, not less, European study finds

Published: December 10, 2014

Gus Cairns
Original Article:

The largest cohort study ever to look at CD4 count and viral loads in HIV-positive people around the time of diagnosis has found evidence that HIV, at least in Europe, has become more virulent over time. The average time taken to reach a CD4 count below 350 cells/mm3 has halved over the last 25 years, researchers calculate.

The study of 15,875 patients within the pan-European CASCADE cohort finds that the estimated CD4 count after seroconversion (a measure of how strongly the acute phase of HIV infection attacks the immune system) fell from 770 cells/mm3 in 1979 to 570 cells/mm3 in 2002.

The average ‘set point’ viral load – the rate at which HIV reproduces in the absence of treatment, after the initial burst of viral replication – increased from 11,200 copies/ml in 1980 to 31,000 copies/ml in 2002 (with a possible slight decline to 25,500 copies/ml by 2008).

The rate at which CD4 counts declined increased during the same time period. This meant that the average time taken for the CD4 count of a person who seroconverted in 1980 to fall below the current UK treatment-initiation threshold of 350 cells/mm3 was seven years; by 2002 this had halved to 3.4 years.

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