Gender Differences In HIV Viral Load May Affect Treatment.

2001 APR 26 - (NewsRx Network) -- by Michael Greer, staff medical writer - Guidelines for using antiretroviral HIV therapies may exclude many women from needed treatment because of gender-based viral load discrepancies, researchers in Maryland warn.

"Currently the guidelines for initiating antiretroviral therapy are applied uniformly to women and men ... [though] it is unclear whether there are differences between men and women with [HIV-1] infection in the plasma level of viral RNA," explained T.R. Sterling and colleagues at Johns Hopkins University.

Sterling et al. found that women usually have far lower levels of viral RNA than men at equivalent disease stages and with similar progression risks. Because of this, current practice in prescribing antiretrovirals based on viral load prevent many women from receiving them, the researchers argued.

Men had a median viral load of almost 51,000 RNA copies/mL at the time of infection, Sterling et al. said. By contrast, the median initial value for female patients was just over 15,000 copies, though CD4 cell counts were similar for both genders.

Many physicians initiate powerful antiretroviral therapy at a viral load of about 20,000 copies/mL. However, even women whose infection progressed to full-blown AIDS showed median initial viral loads of only 17,149 copies/mL, study data showed. Men who progressed to AIDS had median initial viral loads ...