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.

Autor: Macías, J., Leal, M., Delgado, J., Pineda, J. A., Muñoz, J., Relimpio, F., Rubio, A., Rey, C., Lissen, E.
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Zdroj: European Journal of Clinical Microbiology & Infectious Diseases; Apr2001, Vol. 20 Issue 4, p253-259, 7p
Abstrakt: Potential cofactors of survival in HIV-1-infected patients with CD4+ T-cell counts of ≤100 cells/μl were investigated. All 132 patients with CD4+ T-cell counts of ≤100 cells/μl 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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