Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy
Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy
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DOI：
10.1212/wnl.52.3.607
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发表时间：
1999-02-01
期刊：
影响因子：
9.9
通讯作者：
McArthur, JC
中科院分区：
文献类型：
--
作者：
Childs, EA;Lyles, RH;McArthur, JC
目的：确定血浆人类免疫缺陷病毒（HIV）RNA和CD4淋巴细胞对HIV相关痴呆和感觉神经病变的预测价值。
方法：对来自多中心艾滋病队列研究的1604名无艾滋病的HIV血清阳性男性进行了为期10年（1985年至1995年）的随访。根据标准定义诊断HIV相关痴呆和感觉神经病变。使用基线样本通过分支DNA测定法测量血浆HIV RNA水平以及β(2)-微球蛋白水平、CD4淋巴细胞计数和血红蛋白水平。
结果：确定了77例HIV相关痴呆患者和213例感觉神经病变患者。基线HIV RNA水平高于3000拷贝/毫升且CD4计数低于500细胞/立方毫米对两种神经系统结局均有预测作用，但血红蛋白、体重指数和β(2)-微球蛋白均无独立预测作用。在对年龄和教育水平进行调整后，基线血浆HIV RNA＞30000拷贝/毫升的个体患痴呆的相对风险是10000拷贝/毫升者的8.5倍（p＜0.001），患感觉神经病变的风险是其2.3倍（p = 0.008）。
Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy. Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS Cohort Study were followed over a 10-year period (1985 to 1995). HIV-associated dementia and sensory neuropathy were diagnosed according to standard definitions. Baseline samples were used to measure plasma HIV RNA levels with a branched DNA assay and levels of beta(2)-microglobulin, CD4 lymphocyte counts, and hemoglobin levels. Results: Seventy-seven patients with HIV-associated dementia and 213 patients with sensory neuropathy were identified. Baseline HIV RNA levels above 3,000 copies/mL and CD4 counts below 500 cells/mm(3) were predictive of both neurologic outcomes, but neither hemoglobin, body mass index, nor beta(2)-microglobulin were independently predictive. After adjusting for age and level of education, individuals with baseline plasma HIV RNA >30,000 copies/mL had a relative hazard for dementia 8.5 times (p < 0.001) that of those with 10,000 copies/mL had a 2.3-fold (p = 0.008) greater hazard of sensory neuropathy than those with