The influence of age at infection on progression of human immunodeficiency virus (HIV) disease to different clinical endpoints was studied among 393 HIV-seropositive adults selected from the French SEROCO cohort ; follow-up lasted from January 1988 to November 1994.
Selected patients had a known date of infection and were enrolled shortly after seroconversion.
Age-associated risk ratios (RR) were estimated using the Cox model (age fitted as a continuous variable and RR expressed for each 10-year increment after adjustment for symptomatic primary infection and sexual preference).
Age had a weak influence on progression from the date of infection to the first category B event (crude RR=1.15 ; adjusted RR=1.09 ; 95% confidence interval [Cl] : 0.89-1.36) but a marked influence on progression from the first category B to the first category C event (crude RR=1.95 ; adjusted RR=1.97 ; 95% Cl : 1.37-2.79).
Similar results were obtained after adjustment for the CD4+cell count at enrolment.
A qualitative CD4+cell defect could explain the influence of age, but this remains to be confirmed.
Age at infection should be included in the definition of CD4+cell count thresholds for clinical management and treatment initiation.
Risk factors for progression should be assessed according to the different clinical endpoints.
Mots-clés Pascal : SIDA, Virose, Infection, Evolution, Numération, Lymphocyte, Epidémiologie, Homme, Facteur risque, Age, Etude cohorte, Immunopathologie, Immunodéficit, Antigène CD4
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Evolution, Numeration, Lymphocyte, Epidemiology, Human, Risk factor, Age, Cohort study, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0056878
Code Inist : 002B05C02D. Création : 14/05/1998.