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Predictive value of viral load and other markers for progression to clinical AIDS after CD4+ cell count falls below 200/microL. SEROCO & HEMOCO Study Group.

Abstract：

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/microL (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). CONCLUSION:At a late stage of infection, age and persistent thrush remain predictive of progression to AIDS, independently of viral load.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Carré N,Boufassa F,Hubert JB,Chavance M,Rouzioux C,Goujard C,Laurian Y,Meyer L

doi

10.1093/ije/27.5.897

subject

Has Abstract

pub_date

1998-10-01 00:00:00

pages

897-903

issue

5

eissn

0300-5771

issn

1464-3685

journal_volume

27

pub_type

杂志文章

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