HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival
HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival
复制标题
泰国北部夫妇的 HIV-1 E 亚型进展：传统和非传统的生存预测因素
DOI：
10.1093/ije/dyi023
复制
发表时间：
2005-06-01
影响因子：
7.7
通讯作者：
Duerr, A
中科院分区：
文献类型：
--
作者：
Costello, C;Nelson, KE;Duerr, A
背景：在资源有限的环境中不断努力引入抗逆转录病毒治疗，有必要了解不同人群中HIV自然历史的差异，并确定预测生存的可行临床措施。方法对泰国836名感染CRF01_AE亚型HIV的异性恋者进行生存预测分析。结果1993 - 1999年，男性死亡269例（49.4%），女性死亡65例（25.7%）。从估计血清转化到死亡的中位时间为7.8年（95%可信区间7.0-9.1）。CD4计数< 200细胞/亩的男性和女性的死亡风险分别比CD4计数为200-500和100 -500的男性和女性高约2倍和1.1倍。在资源有限的环境中可用的测量，包括总淋巴细胞计数（TLC）、贫血和低体重指数（BMI），也可以预测生存率。具有以上两种预测因子的男性中位生存期为0.8（0.5-1.8）年，而具有一种预测因子的男性中位生存期为2.7（1.9-3.3）年，无预测因子的男性中位生存期为4.9（4.1-5.2）年。结论泰国人群从感染HIV到死亡的时间似乎比未接受抗逆转录病毒治疗的西方人群短。CD4计数和病毒载量（VL）是强有力的、独立的生存预测因子。当CD4计数和VL无法获得时，可能通过低TLC、贫血和低BMI的组合来识别HIV生存期缩短的高危个体。这种可获得的疾病阶段临床测量的结合可能对资源有限的环境中的医疗管理有用。
Background In the continuing effort to introduce antiretroviral therapy in resource-limited settings, there is a need to understand differences between natural history of HIV in different populations and to identify feasible clinical measures predictive of survival.Methods We examined predictors of survival among 836 heterosexuals who were infected with HIV subtype CRF01_AE in Thailand.Results From 1993 to 1999, 269 (49.4%) men and 65 (25.7%) women died. The median time from the estimated seroconversion to death was 7.8 years (95% confidence interval 7.0-9.1). Men and women with enrolment CD4 counts < 200 cells/mu l had about 2 and I I times greater risk of death than those with CD4 counts of 200-500 and > 500, respectively. Measurements available in resource-limited settings, including total lymphocyte count (TLC), anaemia, and low body mass index (BMI), also predicted survival. Men with two or more of these predictors had a median survival of 0.8 (0.5-1.8) years, compared with 2.7 (1.9-3.3) years for one predictor and 4.9 (4.1-5.2) years for no predictors.Conclusions The time from HIV infection to death appears shorter among this Thai population than among antiretroviral naive Western populations. CD4 count and viral load (VL) were strong, independent predictors of survival. When CD4 count and VL are unavailable, individuals at high risk for shortened HIV survival may be identified by a combination of low TLC, anaemia, and low BMI. This combination of accessible clinical measures of the disease stage may be useful for medical management in resource-limited settings.