Usefulness of route of transmission, absolute CD8+ T-cell counts, and levels of serum tumor necrosis factor alpha as predictors of survival of HIV-1-infected patients with very low CD4 + T-cell counts.

Abstract

Potential cofactors of survival in HIV-1-infected patients with CD4+ T-cell counts of < or = 100 cells/microl were investigated. All 132 patients with CD4+ T-cell counts of < or = 100 cells/microl were selected from 416 patients included in an antiretroviral therapy cohort (1989-1999). Fifty of 54 deaths were due to AIDS. There were significant associations (P<0.05) between survival and CD8+ T-cell counts, clinical AIDS stage, risk group, and antiretroviral drug regimen after baseline, but only the use of protease inhibitors had an independent effect on survival (hazard ratio [HR], 0.096; 95% confidence interval [95%CI], 0.094-0.097). A substudy restricted to the cohort of 108 patients never exposed to PIs detected independent associations between survival and CD8+ T-cell counts (P=0.0016), experience with antiretroviral therapy before baseline (HR, 2.52; 95%CI, 1.31-4.82), sexual risk group for HIV infection (HR, 3.7; 95%CI, 1.92-7.12), and levels of serum tumor necrosis factor alpha (P=0.02). This study confirms that the use of PI-containing antiretroviral regimens strongly predicts survival of HIV-1-infected patients with very low CD4+ T-cell counts. When the study was restricted to patients never exposed to PIs, the parenteral route of disease transmission, high absolute CD8 + T-cell counts, and low serum levels of tumor necrosis factor alpha were independent predictors of survival in extremely advanced HIV-1 disease.

• Authors: J Macías, M Leal, J Delgado, J A Pineda, J Muñoz, F Relimpio, A Rubio, C Rey, E Lissen
• Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 20 Issue 4 Pg. 253-9 (Apr 2001) ISSN: 0934-9723 [Print] Germany
• PMID: 11399015 (Publication Type: Journal Article)

Chemical References

• Tumor Necrosis Factor-alpha

Topics

• Acquired Immunodeficiency Syndrome (immunology, mortality, transmission)
• Adolescent
• Adult
• CD4 Lymphocyte Count
• CD8-Positive T-Lymphocytes
• Child
• Female
• HIV-1
• Humans
• Lymphocyte Count
• Male
• Middle Aged
• Tumor Necrosis Factor-alpha (analysis)