|Viral load||Inconsistent surrogate marker||Correlation with CD4+ counts||General|
|HIV protease inhibitors restore impaired T cell proliferative response in vivo and in vitro: a viral-suppression independent mechanism.|| ||Lu W, Andrieu J-M.
| ||“CD4 counts increased and plasma viral load decreased at month 2 in the whole group. However, no significant correlation was found between plasma viral load changes and CD4 count changes at any time point”|
| ||Blood. 2000 Jul 1;96(1):250-8.||2000|
|Genital tract Human Immunodeficiency Virus Type 1 (HIV-1) shedding and inflammation and HIV-1 env diversity in perinatal HIV-1 transmission.|| ||Panther LA et al.
| ||“Peripheral CD4 cell counts did not correlate with levels of HIV-1 in the CVL [cervico-vaginal lavage] by DNA or RNA PCR or by amount of genital tract inflammation”|
| ||JID. 2000 Feb;181:555-63.||2000|
|HIV viral load response to antiretroviral therapy according to baseline CD4 cell count and viral load.|| ||Phillips et al
| ||This study followed 3226 people after initiating "antiretroviral" drugs for the first time. They were followed for up to 192 weeks (over 3 1/2 years) with an average follow up time of 119 weeks. The major objective of the study was to see if people with high "viral loads" had more difficulty in attaining a viral load level below 500 "copies" per mL of blood than people with low "viral loads". They also wanted to make a similar comparison between people who started the study with low CD4 counts and people who had high CD4 counts. They found no difference in viral load level after 32 weeks, no matter what the person's initial viral load or CD4 count was. "In conclusion, in our study there was no strong evidence that lower CD4 cell counts and higher viral loads at baseline are associated with poorer virological (i.e. "viral load") outcome of antiretroviral therapy."These findings cast doubt on the idea that people should have "antiretroviral" drugs started based on CD4 and "viral load" measurements.|
| ||JAMA 286(20); 2560-2567.November 28, 2001||2001|
|The dynamics of T-Lymhyocte turnover in AIDS.|| ||Johnson RP.
| ||“Controversy continues regarding the effects of HAART on CD4 T-cell production...our understanding the mechanisms that lead to depletion of CD4 T cells remains incomplete. The observation that T-cell turnover in SIV-infected mangabeys appears to be normal, despite high viral loads, has reinforced the hypothesis that indirect mechanisms may be largely responsible for increases in T-cell turnover, yet there is little solid evidence on how HIV and SIV mediate this effect [translation: we don’t have a clue how HIV kills CD4 cells]”|
| ||AIDS. 2000;14(suppl 3):S3-9.||2000|
|Analysis of apoptosis in lymph nodes of HIV-infected persons. Intensity of apoptosis correlates with the general state of activation of the lymphoid tissue and not with stage of disease or viral burden.|| ||Muro-Cacho, C. A., Pantaleo, G., Fauci, A.S.
| ||“apoptosis was not restricted only to CD4+ T cells; both B cells and CD8+ T cells were found to undergo apoptosis. Taken together, these results indicate that the increased intensity of the apoptotic phenomenon in HIV infection is caused by the general state of immune activation, and is independent of the progression of HIV activities and the levels of viral load”.|
| ||J. Immunol 154 (10):5555-66, 1995||1995|
|Disputing a Theory About AIDS Progression : Evidence suggests that a decrease in CD4 + T cells is not a death sentence|| ||Kling Jim
| ||For this article, Jim Kling interviewed Louis J. Picker, associate director of the Vaccine and Gene Therapy Institute at the Oregon Health Sciences University : "There was no clear-cut association between viral load and the [numbers] of these cells," says Picker, suggesting that HIV-specific CD4+ T cell levels are not an accurate marker of disease progression.|
| ||The Scientist 15:17, May 14, 2001||2001|
|High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR.|| ||Piatak M Jr et al.
| ||This study showed that viral load test results do not correlate with ...T cell counts|
| ||Science. 1993 Mar 19;259:1749-54.||1993|