Trends in Post-Infection CD4 Cell Counts and Plasma HIV-1 RNA Levels in HIV-1-Infected Patients in France Between 1997 and 2005

Objective: We studied trends in initial post infection CD4 cell counts and viral load values in patients diagnosed at estimated time of primary infection between 1997 and 2005 in France. Population and Methods: We selected from the French Hospital Database on HIV infection white patients with documented dates of sexually transmitted HIV-1 infection who had a first CD4 cell count (n = 1441) or viral load assay (n = 1402) within 12 months after infection and before any antiretroviral therapy. Chronological trends in initial CD4 cell counts and viral load values were studied by using linear regression analysis. Results: The initial CD4 cell count declined by an average of 5.76 cells per cubic millimeter per year [95% confidence interval (CI): -11.28 to -0.24 cells/mm(3) per year] and compared with 1997 initial viral load increased significantly by a mean of 0.376 log(10) copies per milliliter (95% CI: 0.044 to 0.707 log(10) copies/mL) in 1999, 0.548 log(10) copies per milliliter (95% CI: 0.288 to 0.808 log(10) copies/mL) in 2000-2002, and 0.525 log(10) copies per milliliter (95% CI: 0.267 to 0.7783 log(10) copies/mL) in 2003-2005. Conclusion: We think that lower CD4 cell counts and higher viral loads at a given time post infection suggest a more rapid progression of the disease and therefore an increased HIV pathogenicity.