Papers

Use of CD4 lymphocyte count to predict long term survival free of AIDS after HIV infection

University Department of Public Health, Royal Free Hospital and School of Medicine, London NW3 2PF Department of Clinical Immunology, Royal Free Hospital and School of Medicine, London NW3 2PF Haemophilia Centre, Royal Free Hospital and School of Medicine, London NW3 2PF Correspondence to: Dr Phillips.

Abstract

Objective : To estimate the probability of remaining free of AIDS for up to 25 years after infection with HIV by extrapolation of changes in CD4 lymphocyte count.
Design : Cohort study of subjects followed from time of HIV seroconversion until 1 January 1993. Creation of model by using extrapolated linear20regression slopes of CD4 count to predict development of AIDS after 1993.
Setting : Regional haemophilia centre in teaching hospital.
Subjects : 111 men with haemophilia infected with HIV during 1979-85. Median length of follow up 10.1 years, median number of CD4 counts 17. The model was not fitted for three men because only one CD4 measurement was available.
Main outcome measures : Development of AIDS.
Interventions : From 1989 prophylaxis against candida and Pneumocystis carinii pneumonia and antiretroviral drugs when CD4 count fell below 200x10⁶/l.
Results : 44 men developed AIDS up to 1 January 1993. When AIDS was defined as a CD4 count of 50x10⁶/l the model predicted that 25% (95% confidence interval 16% to 34%) would survive for 20 years after seroconversion and 18% (11% to 25%) for 25 years. Changing the CD4 count at which AIDS was assumed to occur did not alter the results. Younger patients had a higher chance of 20 year survival than older patients (32% (12% to 52%) for those aged <15, 26% (14% to 38%) for those aged 15-29, and 15% (0% to 31%) for those aged >=30).
Conclusions : These results suggest that even with currently available treatment up to a quarter of patients with HIV infection will survive for 20 years after seroconversion without developing AIDS.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Using CD4 lymphocyte count to predict survival with HIV infection

V Harindra
BMJ 1994 309: 877. [Extract] [Full Text]

This article has been cited by other articles:

• Lugada, E. S., Mermin, J., Kaharuza, F., Ulvestad, E., Were, W., Langeland, N., Asjo, B., Malamba, S., Downing, R. (2004). Population-Based Hematologic and Immunologic Reference Values for a Healthy Ugandan Population. CVI 11: 29-34 [Abstract] [Full text]  
• Moscucci, O. (2001). Garibaldi and the surgeons. JRSM 94: 248-252 [Full text]  
• Dunn, P. M (1999). Robert Felkin MD (1853-1926) and Caesarean delivery in Central Africa (1879). Arch. Dis. Child. Fetal Neonatal Ed. 80: 250F-251 [Full text]  
• Lee, C., Sabin, C., Miners, A. (1997). High cost, low volume care: the case of haemophilia. BMJ 315: 962-963 [Full text]  
• Phillips, A. N, Smith, G. D., Johnson, M. A (1996). For Debate: Will we ever know when to treat HIV infection?. BMJ 313: 608-610 [Full text]  
• Harindra, V (1994). Using CD4 lymphocyte count to predict survival with HIV infection. BMJ 309: 877-877 [Full text]  
• Rutherford, G W (1994). Long term survival in HIV-1 infection. BMJ 309: 283-284 [Full text]