Immunological and serological markers predictive of progression to AIDS in a cohort of HIV-infected drug users

Fernández‐Cruz, Eduardo; Desco, M.; M, Garcia Montes; Longo, Nancy S.; González, Blanca; Jm, Zabay

doi:10.1097/00002030-199010000-00007

Cited by 61 publications

(26 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…None of these additional parameters has the predictive potential of CD4 + lymphocyte count; their predictive value in combination with CD4 + lymphocyte count is confroversial [13,14,17,20,21,[25][26][27].…”

mentioning

confidence: 99%

Improvement of the predictive value of CD4 + lymphocyte count by β2-microglobulin, immunoglobulin A and erythrocyte sedimentation rate

Schwartländer¹,

Bek²,

Skarabis³

et al. 1993

AIDS

View full text Add to dashboard Cite

for the multicentre cohort study group t Objective: To evaluate whether the use of immunological markers in addition to CD4+ Iymphocyte count can improve the prediction of the probability of developing AIDS within a given period. Design and setting:Prospective multicentre cohort study of homosexual men. Patients:A total of 447 HIV-positive homosexual men followed prospectively at 6-month intervals (median time of observation, 47 months). Methods:Estimation of AIDS-free time using lifetable plots by Cutler and Ederer and Weibull parametric models. A stepwise multivariate regression analysis was used to calculate the optimal combination of the parameters studied. Results:In general CD4+ Iymphocyte counts are most important for the prediction of AIDS-free time. The use of serum levels of ß2-microglobulin (ß2M), immunoglobulin A (lgA) and erythrocyte sedimentation rate (ESR) can significantly improve the predictive value of CD4 + Iymphocyte counts. However, the usefulness of these parameters depends on the stage of HIV disease. In patients with a CD4 + Iymphocyte count > 500 x 10 6 /1 , only IgA level had a significant predictive value; none of the other parameters significantly improved the model. In patients with a CD4 + Iymphocyte count< 500 x 10 6 /1 , the absolute number of CD4+ cells itself was the most important single predictive parameter, but the prediction of AIDS was significantly improved by the addition of the other parameters investigated. The most powerful combination of parameters in this group was CD4 + count, ß2M and ESR. Conclusion:Determination of serum IgA, ß2M and ESR in addition to CD4 + Iymphocyte count may aid the choice of specific therapeutic regimens or systems of care for HIV-positive individuals. AIDS 1993, 7:813-821

show abstract

mentioning

confidence: 99%

Improvement of the predictive value of CD4 + lymphocyte count by β2-microglobulin, immunoglobulin A and erythrocyte sedimentation rate

Schwartländer¹,

Bek²,

Skarabis³

et al. 1993

AIDS

View full text Add to dashboard Cite

show abstract

“…Some associations, for example, were defined in terms of CD4 + counts lower than 300, 400, or even 500 cells/mm 3 (Polk et al 1987, Pedersen et al 1989, Anderson et al 1990). Other studies, however, have indicated that an AIDS-defining illness was actually more likely to occur in patients with CD4 + counts lower than 200 cells/mm 3 (Moss et al 1988, Goedert et al 1989, Fernández-Cruz et al 1990, Rabeneck et al 1993. Analysis based on data from 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5cont.…”

Section: Immunological Markersmentioning

confidence: 97%

“…Goedert, Kessler, Aledort, et al (1989) 23. Fernández-Cruz et al (1990) 30. Jacobson et al (1991) 20.…”

Section: Immunological Markersunclassified

“…Alcabes et al (1994) OUTCOME: (Alcabes et al 1994). In addition, it is of interest the fact that two studies found no other laboratory variables to be independently predictive of AIDS after controlling for CD4 + counts (Fernández-Cruz et al 1990, Alcabes et al 1994. In a study not included in Table I, Farizo et al (1992) not only pointed out that the risk of occurrence of an AIDS-defining disease was higher among patients with less than 200 CD4 + cells/mm 3 , but also that it increased progressively with lower CD4+ count levels.…”

Section: Immunological Markersmentioning

confidence: 99%

“…Anergy -Anergy, defined as the lack of cutaneous response to some specific antigens, has also been analyzed as a marker of HIV disease (MacDonell et al 1988, Fernández-Cruz et al 1990). It was used as a criterium in the Walter Reed staging system, one of the first proposed for classifyng the HIV-infected patients.…”

Section: Immunological Markersmentioning

confidence: 99%

See 2 more Smart Citations

Markers, Cofactors and Staging Systems in the Study of HIV Disease Progression: A Review

Portela

Simpson

1997

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

CD4+ T-Lymphocyte Measures in the Treatment of Individuals Infected With Human Immunodeficiency Virus Type 1

1994

View full text Add to dashboard Cite

The CD4+ lymphocyte is a major target of the human immunodeficiency virus type 1 (HIV-1). CD4+ T-lymphocyte measures have been used to predict the risk of HIV-1-related complications in diverse populations, to guide management decisions, and to define cases of the acquired immunodeficiency syndrome (AIDS). To examine the role of CD4+ measures in the management and epidemiologic monitoring of HIV-1 infection, we evaluated current literature regarding the accuracy and precision of CD4+ measures and the use of these and other prognostic measures in the care of HIV-1-infected persons. Several studies have reported wide intraindividual and interindividual variability in the absolute CD4+ count, which can detract from its clinical usefulness. Approaches to address this variability include the following: drawing specimens at a similar time of the day; monitoring CD4+ percent that has less variability; following a meticulous laboratory technique; using serial tests to guide management decisions; and retesting after efforts to eliminate transient treatment and clinical factors that can affect the CD4+ count. The expense and limited availability of CD4+ measures also present barriers to widespread use. Other laboratory and clinical factors offer additional prognostic information and have an evolving role in management decisions. CD4+ measures have an important role in HIV-1 clinical care, research, and disease surveillance, but strategies are required to address problems with variability, expense, and availability.

show abstract

Immunological and serological markers predictive of progression to AIDS in a cohort of HIV-infected drug users

Cited by 61 publications

References 0 publications

Improvement of the predictive value of CD4 + lymphocyte count by β2-microglobulin, immunoglobulin A and erythrocyte sedimentation rate

Improvement of the predictive value of CD4 + lymphocyte count by β2-microglobulin, immunoglobulin A and erythrocyte sedimentation rate

Markers, Cofactors and Staging Systems in the Study of HIV Disease Progression: A Review

CD4+ T-Lymphocyte Measures in the Treatment of Individuals Infected With Human Immunodeficiency Virus Type 1

Contact Info

Product

Resources

About