CD4 and total lymphocyte counts as predictors of HIV disease progression.
CD4+T-lymphocyte (CD4) counts are a standard laboratory marker of disease progression in HIV infection, but expense precludes their use in large parts of the world.
Total lymphocyte counts (TLC), in contrast, are widely available.
We compared CD4 and TLC counts as predictors of developing AIDS or death in 831 HIV-positive out-patients (582 males and 249 females with both homosexual (males, n=316) and heterosexual (n=515) transmission patterns.
The first CD4 count<200/mu1 and first TLC<1250/mu1 predicted similar (p=0.52) survival, irrespective of clinical stage.
For each clinical stage, a significant difference in progression to AIDS and mortality was predicted by TLC above or below 1250/mul (p<0.03).
Survival and progression to AIDS occurred at similar rates in patients with a TLC<1250/mul or a CD4 count<200/mul (p>0.1), and patients with a TLC>1250/mul or a CD4 count>200/mul (p>0.5).
A TLC<1 250/mul preceded the development of Pneumocystis carinii pneumonia or cerebral toxoplasmosis in 76% of patients.
In this longitudinal study, TLC and CD4 counts were equal predictors of disease progression.
A TLC<1250/mul could be considered an indication for commencing cotrimoxazole prophylaxis.
Mots-clés Pascal : SIDA, Virose, Infection, Homme, Facteur risque, Evolutivité, Etude comparative, Comptage, Lymphocyte T, Sous population cellulaire, Survie, Epidémiologie, Phénotype, Surface cellulaire, Immunopathologie, Immunodéficit, Antigène CD4
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human, Risk factor, Evolutivity, Comparative study, Counting, T-Lymphocyte, Cell subpopulation, Survival, Epidemiology, Phenotype, Cell surface, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0352530
Code Inist : 002B06D01. Création : 10/04/1997.