SynthesisAIDS (London, England)2012
Is the virulence of HIV changing? A meta-analysis of trends in prognostic markers of HIV disease progression and transmission.
Synthesis in AIDS (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Does Sickle Cell Disease Protect against HIV Infection: A Systematic Review.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2022Pooled it
- Trial
- Molecular epidemiology of HIV-1 in Hungary: an evolving contact zone of colliding virus subtypes.Frontiers in microbiology · 2025Article
- The genetic architecture of HIV-1 virulence.Virus evolution · 2025Article
- Evidence for circulation of high-virulence HIV-1 subtype B variants in the United Kingdom.Virus evolution · 2025Article
- Do pathogens always evolve to be less virulent? The virulence-transmission trade-off in light of the COVID-19 pandemic.Biologia futura · 2023Review
- Why does age at HIV infection correlate with set point viral load? An evolutionary hypothesis.Epidemics · 2022Article
- Controlling long-term SARS-CoV-2 infections can slow viral evolution and reduce the risk of treatment failure.Scientific reports · 2021Article
- Test-and-treat coverage and HIV virulence evolution among men who have sex with men.Virus evolution · 2021Article
- Natural selection favoring more transmissible HIV detected in United States molecular transmission network.Nature communications · 2019Article
- Review
- Clinical and evolutionary consequences of HIV adaptation to HLA: implications for vaccine and cure.Current opinion in HIV and AIDS · 2019Review
- Evolution of the Envelope Glycoprotein of HIV-1 Clade B toward Higher Infectious Properties over the Course of the Epidemic.Journal of virology · 2019Article
- The phylogenomics of evolving virus virulence.Nature reviews. Genetics · 2018Review
- Relational concurrency, stages of infection, and the evolution of HIV set point viral load.Virus evolution · 2018Article
- Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study.PLoS medicine · 2017Article
- Host genetic variation and HIV disease: from mapping to mechanism.Immunogenetics · 2017Review
- Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe.PLoS biology · 2017Article
- Modelling the evolution of HIV-1 virulence in response to imperfect therapy and prophylaxis.Evolutionary applications · 2017Article
- Effects of contact structure on the transient evolution of HIV virulence.PLoS computational biology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectiveThe potential for changing HIV-1 virulence has significant implications for the AIDS epidemic, including changing HIV transmission rates, rapidity of disease progression, and timing of ART. Published data to date have provided conflicting results.
designWe conducted a meta-analysis of changes in baseline CD4(+) T-cell counts and set point plasma viral RNA load over time in order to establish whether summary trends are consistent with changing HIV-1 virulence.
methodsWe searched PubMed for studies of trends in HIV-1 prognostic markers of disease progression and supplemented findings with publications referenced in epidemiological or virulence studies. We identified 12 studies of trends in baseline CD4(+) T-cell counts (21, 052 total individuals), and eight studies of trends in set point viral loads (10 ,785 total individuals), spanning the years 1984-2010. Using random-effects meta-analysis, we estimated summary effect sizes for trends in HIV-1 plasma viral loads and CD4(+) T-cell counts.
resultsBaseline CD4(+) T-cell counts showed a summary trend of decreasing cell counts [effect = -4.93 cells/μl per year, 95% confidence interval (CI) -6.53 to -3.3]. Set point viral loads showed a summary trend of increasing plasma viral RNA loads (effect = 0.013 log(10) copies/ml per year, 95% CI -0.001 to 0.03). The trend rates decelerated in recent years for both prognostic markers.
conclusionOur results are consistent with increased virulence of HIV-1 over the course of the epidemic. Extrapolating over the 30 years since the first description of AIDS, this represents a CD4(+) T cells loss of approximately 148 cells/μl and a gain of 0.39 log(10) copies/ml of viral RNA measured during early infection. These effect sizes would predict increasing rates of disease progression, and need for ART as well as increasing transmission risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.