Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In a study reporting that plasma human immunodeficiency virus 1 (HIV-1) RNA explains less than 10% of the variability in CD4 cell count slope in patients with untreated HIV-1 infection, Rodríguez et al1 questioned viral replication as the main determinant of progressive immunodeficiency. That study did not include the clinically important outcomes of AIDS or death and did not provide data on variability of CD4 cell count slopes. We therefore evaluated the prognostic strength of HIV-1 RNA, CD4 cell count,2,3 and CD4 cell count slope for clinical outcomes, as well as the variance of CD4 cell count slope.
Mellors JW, Margolick JB, Phair JP, Rinaldo CR, Detels R, Jacobson LP, Muñoz A. Prognostic Value of HIV-1 RNA, CD4 Cell Count, and CD4 Cell Count Slope for Progression to AIDS and Death in Untreated HIV-1 Infection. JAMA. 2007;297(21):2346-2350. doi:10.1001/jama.297.21.2349