Prognostic indicators for AIDS and infectious disease death in HIV-infected injection drug users -: Plasma viral load and CD4+ cell count
Prognostic indicators for AIDS and infectious disease death in HIV-infected injection drug users -: Plasma viral load and CD4+ cell count
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DOI：
10.1001/jama.279.1.35
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发表时间：
1998-01-07
影响因子：
120.7
通讯作者：
Farzadegan, H
中科院分区：
文献类型：
--
作者：
Vlahov, D;Graham, N;Farzadegan, H
背景。-血浆人类免疫缺陷病毒1型（HIV-1）病毒载量和CD 4（+）细胞计数用于预测HIV感染者的预后。然而，结合这些标志物是否可以提高预后的准确性，以及它们是否可以预测注射吸毒者（IDUs）和感染艾滋病毒的非白人的预后尚未得到广泛的研究。评估血浆病毒载量和CD 4（+）细胞计数作为获得性免疫缺陷综合征（AIDS）和感染性疾病死亡的预后指标。队列研究于1988年和1989年开始，随访时间长达7.9年。从马里兰州巴尔的摩社区招募的感染HIV的注射吸毒者。基线时测量的血浆HIV-1 RNA和CD 4（+）细胞计数与首次临床AIDS诊断和因感染性疾病死亡的时间比较。在522例受试者中，96%为非洲裔美国人，80%为男性，96%在过去6个月内注射过药物，中位年龄为33岁。在中位6.4年的随访期间，共发现146例艾滋病病例和119例传染病死亡病例。病毒载量和CD 4（+）细胞计数的时间固定基线水平是进展为艾滋病和传染病死亡的独立预测因子，但在比例风险模型中，病毒载量比CD 4（+）细胞计数具有更好的预测价值。Kaplan-Meier分析至艾滋病和传染病死亡时间的病毒载量（
Context.-Plasma human immunodeficiency virus type 1 (HIV-1) viral load and CD4(+) cell count are used to predict prognosis of persons infected with HIV. However, whether combining these markers improves prognostic accuracy and whether they predict prognosis for injection drug users (IDUs) and nonwhite persons infected with HIV has not been extensively investigated.Objective.-To evaluate plasma viral load and CD4(+) cell count as prognostic indicators for the acquired immunodeficiency syndrome (AIDS) and infectious disease deaths.Design.-Cohort study initiated in 1988 and 1989 with follow-up for up to 7.9 years.Participants.-Injection drug users infected with HIV recruited from the community in Baltimore, Md.Main Outcome Measures.-Plasma HIV-1 RNA and CD4(+) cell count measured at baseline compared with time to first clinical AIDS diagnosis and death due to an infectious disease.Results.-Of 522 subjects, 96% were African American, 80% were male, 96% injected drugs within the past 6 months, and the median age was 33 years. A total of 146 cases of AIDS and 119 infectious disease deaths were seen during a median follow-up period of 6.4 years. Time-fixed baseline levels of viral load and CD4(+) cell count were independent predictors of progression to AIDS and infectious disease deaths, but in proportional hazards models, viral load had better predictive value than CD4(+) cell count. Kaplan-Meier analysis of time to AIDS and to infectious disease deaths by Viral load (