Serial CD4 lymphocyte counts and development of AIDS

Lee, ChristineA.; Kernoff, PeterB.A.; Phillips, AndrewN.; Elford, Jonathan; Jánossy, G.; Timms, Anthony; Bofill, Margarita

doi:10.1016/0140-6736(91)91166-r

Cited by 257 publications

(20 citation statements)

References 21 publications

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“…Such studies led some to conclude that differences in AIDS progression rates can largely be explained by differences in rates of CD4 cell decline [25]. However the reverse is not necessarily true—sudden falls in CD4 cell count are not always a precursor to AIDS.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment CD4 Cell Slope and Progression to AIDS or Death in HIV-Infected Patients Initiating Antiretroviral Therapy—The CASCADE Collaboration: A Collaboration of 23 Cohort Studies

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Pretreatment CD4 Cell Slope and Progression to AIDS or Death in HIV-Infected Patients Initiating Antiretroviral Therapy—The CASCADE Collaboration: A Collaboration of 23 Cohort Studies

et al. 2010

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“…The decline compared to no decline of CD4+ T cells over a short period would be easily available for many clinical situations and might help the clinician to assess the rate of disease progression. The CD4+ T cell count has to be included in a time–dependent fashion [9, 30]. We disregarded this kind of analysis, since the frequency of the CD4+ T cell count in injecting drug users was much less than in the other study participants and this might have violated the results substantially.…”

Section: Discussionmentioning

confidence: 99%

Serum HIV–1 RNA Levels Compared to Soluble Markers of Immune Activation to Predict Disease Progression in HIV–1–Infected Individuals

Zangerle¹,

Steinhuber²,

Sarcletti³

et al. 1998

Int Arch Allergy Immunol

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We assessed the value of HIV–1 RNA level compared to soluble immune activation markers, namely neopterin, β₂–microglobulin and soluble TNF receptor 75 (sTNFR–75), to predict the change in the number of CD4+ T cells over a 1–year period, the development of AIDS, and survival (median follow–up 54 months). The study population comprised a cohort of 47 individuals for the analysis of the change in CD4+ T cells and survival (20 died), and a subgroup of 31 individuals with a baseline CD4+ T cells above 200×10⁶/l for the development of AIDS (11 developed AIDS). HIV–1 RNA was measured from stored sera by quantitative PCR. The CD4+ T cell count obtained at study entry strongly correlated with baseline serum HIV–1 RNA levels (r = –0.47), and to a lesser extent with neopterin (r = –0.41) and β₂–microglobulin (r = –0.29). The percentage change in CD4+ T cells over a 1–year period correlated with HIV–1 RNA levels (r = –0.32, p = 0.03), however, stronger correlations were found for neopterin, β₂–microglobulin and sTNFR–75 (r = –0.51, r = –0.41, r = –0.42; p<0.01). No progression to AIDS or death was observed in individuals with baseline HIV–1 RNA levels below 20,000 copies/ml (10 of 31 and 15 of 47 individuals, respectively). A Cox’s proportional hazard model to predict AIDS revealed that HIV–1 RNA, the change in CD4+ cells over a 1–year period and sTNFR–75 levels independently predict AIDS; the change in CD4+ cells, the absolute CD4+ T cell count and neopterin were jointly significant to predict death. All results were adjusted for nucleoside monotherapy. In conclusion, to improve the predictive power, quantitation of HIV–1 RNA as a 'natural history marker’ may be supplemented by measurement of sTNFR–75 for 'early’–stage disease progression and neopterin for 'late’–stage disease progression.

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“…Thus, the decline of CD4+ T cells reflects what we know about the mechanistic basis of the disease. CD4+ T-cell declines have also been found to be independent predictors of disease progression in the Swiss HIV Cohort [21] that we analyzed here and other cohorts [22]. Importantly, the rate of decline can be calculated in a much shorter time scale than the direct observation of disease progression requires.…”

Section: Introductionmentioning

confidence: 99%