Serum albumin as a prognostic indicator for HIV disease progression
Serum albumin as a prognostic indicator for HIV disease progression
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DOI：
10.1089/aid.2006.22.14
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发表时间：
2006-01-01
影响因子：
1.5
通讯作者：
Vlahov, D
中科院分区：
文献类型：
--
作者：
Mehta, SH;Astemborski, J;Vlahov, D
低白蛋白水平与HIV的进展有关。这项分析的目的是证实这种联系，并进一步检查艾滋病毒血清转换前后白蛋白对疾病进展的影响。首先在进入社区队列时已经感染艾滋病毒的个人(n=453)中检查了这种相关性，并在艾滋病毒血清转换者中进一步评估了白蛋白浓度在血清转换之后(n=219)和血清转换之前(n=138)的浓度。用COX回归分析白蛋白对艾滋病、艾滋病死亡率和全因死亡率的预后影响。在453名HIV感染者中，35克/升的白蛋白与更快地进展为艾滋病[调整后的相对危险度(ARH)，1.8；95%可信区间(CI)，1.2-2.8]、艾滋病死亡率(ARH，2.2；95%可信区间，1.3-3.8)和全因死亡率(ARH，2.4；95%CI，1.6-3.5)有关。仅限于艾滋病毒血清转换者的分析也是相似的。白蛋白的预转换水平不能预测结果，但HIV血清转换似乎降低了白蛋白水平。这些数据表明，艾滋病毒血清转换后的白蛋白水平为35克/升，与艾滋病毒疾病进展较快有关，并表明低白蛋白水平可能是艾滋病毒感染的结果，而不仅仅是反映了一些人天生就有低白蛋白水平。
Low albumin levels have been associated with HIV progression. The objective of this analysis was to confirm this association and to further examine the effect of albumin before and after HIV seroconversion on disease progression. The association was first examined among individuals already infected with HIV at entry into a community-based cohort (n = 453) and further assessed among HIV seroconverters with albumin concentrations measured after (n = 219) and before seroconversion (n = 138). The prognostic effect of albumin on AIDS, AIDS mortality, and all-cause mortality was examined using Cox regression. Among 453 HIV-infected individuals, albumin < 35 g/liter was associated with faster progression to AIDS [ adjusted relative hazard (ARH), 1.8; 95% confidence interval (CI), 1.2-2.8], AIDS mortality (ARH, 2.2; 95% CI, 1.3-3.8), and all-cause mortality (ARH, 2.4; 95% CI, 1.6-3.5). Analyses restricted to HIV seroconverters were similar. Preseroconversion levels of albumin did not predict outcomes, but HIV seroconversion appeared to lower albumin levels. These data show that albumin < 35 g/liter after HIV seroconversion is associated with faster HIV disease progression and suggest that low albumin levels are probably a consequence of HIV infection rather than merely reflective of some individuals inherently having low albumin levels.