Predictive value of viral load and other markers for progression to clinical AIDS after CD4+cell count falls below 200/muL.
Background To assess the predictive value of biological and clinical events for progression to AIDS (1993 European classification) when the CD4+cell count falls below 200/muL (CD4 threshold) in different exposure groups.
To investigate whether such markers remain predictive independently of the serum HIV-1 RNA level at the CD4 threshold.
Methods The predictive value of biological and clinical events occurring during the 24 months prior to the occurrence of CD4 threshold (n=333) was quantified in a Cox model.
Another Cox model was carried out in a subset of 77 patients in whom viral load from stored sera was available.
Furthermore, changes in viral load during the 24 months preceding the CD4 threshold were assessed in a mixed model according to subsequent development of AIDS.
Results Among the 333 patients, the slope of the CD4+cell counts, the emergence of p24 antigen, persistent thrush, and age at the CD4 threshold were independent predictors of progression to clinical AIDS (44.7%). Among the subset of 77 patients, the HIV-1 RNA level at the CD4 threshold, persistent thrush and age remained independent predictors of progression to AIDS (45.5%). The increase of the HIV-1 RNA level was moderate, both in non-progressors (24.0% per year) and in those who subsequently developed AIDS (27.1% per year), (P=0.93).
Viral load was consistently higher in the latter group (P=0.002). (...)
Mots-clés Pascal : SIDA, Virose, Infection, Marqueur biologique, Charge virale, Lymphocyte, Plasma sanguin, Epidémiologie, Facteur prédictif, Pronostic, Homme, France, Europe, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Biological marker, Viral load, Lymphocyte, Blood plasma, Epidemiology, Predictive factor, Prognosis, Human, France, Europe, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0000459
Code Inist : 002B05C02D. Création : 31/05/1999.