The Risk of Disease Progression Is Determined during the First Year of Human Immunodeficiency Virus Type 1 Infection

A cohort of 103 human immunodeficiency virus type 1 (HIV-1)-infected persons with well-defined dates of seroconversion were studied to determine whether baseline plasma HIV RNA loads 6-12 months after seroconversion have prognostic value. Baseline plasma virus loads had predictive value for the disease-free survival rate and for the survival rate. The level of baseline HIV RNA also had a strong negative predictive value for the CD4 + T cell count during the fifth year of infection: A baseline load >5 log was predictive of a CD4 + T cell count <500/mm 3 5 years after infection. Baseline HIV RNA load was a CD4 + T cell-independent predictor of progression to death. The major finding was that the disease outcome for HIV-1-infected persons is already determined during the first year of infection.