Date of download: 6/3/2016 From: Report of the NIH Panel To Define Principles of Therapy of HIV Infection* Ann Intern Med. 1998;128(12_Part_2): doi: / _Part_ Generalized time course of HIV infection and disease.Three patterns of disease progression: rapid, intermediate, and late progression. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 6/3/2016 From: Report of the NIH Panel To Define Principles of Therapy of HIV Infection* Ann Intern Med. 1998;128(12_Part_2): doi: / _Part_ AIDS-free survival by baseline plasma HIV RNA levels and CD4+ T-cell counts.[27]P[27]33Kaplan-Meier curves showing AIDS-free survival by plasma HIV RNA category among groups of persons with different baseline CD4+ T-cell counts who participated in the Multicenter AIDS Cohort Study. The five categories of baseline HIV RNA levels were I] ≤ 500, II) , III] , IV) , and V) > copies/mL of plasma. Within each CD4+ T-cell category, baseline HIV RNA concentration provided significant discrimination of AIDS-free times ( < 0.001) and survival times. In the lowest CD4+ T-cell category (<200 cells/mm ), there were too few participants with HIV RNA concentrations of ≤ copies/mL to provide reliable estimates for RNA categories I to III. In the next lowest CD4+ T-cell categories ( and cells/mm ), there were too few participants with HIV RNA concentrations of ≤ 500 copies/mL (category I) to provide reliable estimates. Plasma HIV RNA concentrations were measured by using the Quantiplex HIV RNA branched DNA assay (Chiron Diagnostics, Emeryville, California). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 6/3/2016 From: Report of the NIH Panel To Define Principles of Therapy of HIV Infection* Ann Intern Med. 1998;128(12_Part_2): doi: / _Part_ Association between rates of decline of CD4+ T-cell counts and baseline plasma HIV RNA level.[27]The relationship between baseline HIV-1 RNA level and the subsequent rate of decline in CD4+ T cells seen in participants of the Multicenter AIDS Cohort Study. The study population was divided into five categories of plasma HIV-1 RNA defined by baseline levels of 1) ≤ 500, 2) , 3) , 4) , and 5) > copies/mL of plasma. The estimated mean slope of decline in CD4+ T cells (number of cells lost per year) and 95% CIs by plasma HIV-1 RNA category are shown. The estimated rates of decline in CD4+ T-cell counts are substantially different for each of the five baseline HIV RNA categories and show a monotonic relationship; that is, the higher the baseline HIV RNA concentration, the greater the rate of decline of the CD4+ T- cell count. Plasma HIV RNA concentrations were measured by using the Quantiplex HIV RNA branched DNA assay (Chiron Diagnostics, Emeryville, California). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 6/3/2016 From: Report of the NIH Panel To Define Principles of Therapy of HIV Infection* Ann Intern Med. 1998;128(12_Part_2): doi: / _Part_ Probability of AIDS by baseline HIV RNA level and CD4+ T-cell count.[27]A regression tree containing 14 distinct categories of risk for progression to AIDS defined among participants in the Multicenter AIDS Cohort Study. The risk for progression to AIDS can be assessed for many infected persons through the combined analysis of their baseline HIV RNA levels and CD4+ T-cell counts. The number of study participants in each group is indicated by “N.” Risk for AIDS with 95% CIs appears at the bottom of the figure. Plasma HIV RNA concentrations were measured by using the Quantiplex HIV RNA branched DNA assay (Chiron Diagnostics, Emeryville, California). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 6/3/2016 From: Report of the NIH Panel To Define Principles of Therapy of HIV Infection* Ann Intern Med. 1998;128(12_Part_2): doi: / _Part_ Rate of decline of plasma HIV RNA level after initiation of potent combination antiretroviral therapy.1010[37, 39]A representative time course of rate of decline in plasma HIV RNA concentration (in log copies of RNA/mL) following initiation of a potent regimen of combination antiretroviral therapy (e.g., two nucleoside analogue reverse transcriptase inhibitors [i.e., zidovudine and lamivudine] plus a potent, bioavailable protease inhibitor [i.e., indinavir, nelfinavir, or ritonavir]). The first phase of decline is a rapid, approximately 2-log (100-fold) decrease in plasma HIV RNA concentrations. The slope of this first phase of decline in plasma RNA levels is very similar between different persons initiating effective antiretroviral therapies. A second, more gradual phase of decline in plasma HIV RNA levels is seen over subsequent weeks, the slope of which varies between different treated persons. Many effectively treated persons will demonstrate declines in plasma RNA levels to below the limits of assay detection (500 copies RNA/mL) by approximately 8 weeks after initiation of antiretroviral therapy, although some persons may take longer to demonstrate undetectable virus. When plasma HIV RNA levels decrease below detection, the absolute nadir is unknown. However, plasma HIV RNA levels have decreased below the detection limits of even more sensitive assays (sensitivity of 25 RNA copies/mL) in many effectively treated persons. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians