DISTRIBUTION OF CD4(+) T-LYMPHOCYTES AT DIAGNOSIS OF ACQUIRED IMMUNODEFICIENCY SYNDROME-DEFINING AND OTHER HUMAN IMMUNODEFICIENCY VIRUS-RELATED ILLNESSES
DISTRIBUTION OF CD4(+) T-LYMPHOCYTES AT DIAGNOSIS OF ACQUIRED IMMUNODEFICIENCY SYNDROME-DEFINING AND OTHER HUMAN IMMUNODEFICIENCY VIRUS-RELATED ILLNESSES
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DOI：
10.1001/archinte.155.14.1537
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发表时间：
1995-07-24
影响因子：
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通讯作者：
CORONADO, VG
中科院分区：
文献类型：
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作者：
HANSON, DL;CHU, SY;CORONADO, VG
背景资料：在感染人类免疫缺陷病毒（HIV）的人群中，循环中CD 4（+）T淋巴细胞的耗竭与机会性、危及生命的疾病和死亡的风险增加有关。描述获得性免疫缺陷综合征（AIDS）和其他疾病最初发生时的CD 4（+）T淋巴细胞水平，我们分析了1990年1月至1993年8月期间在美国10个城市的100多家诊所、医院和私人诊所接受治疗的18062名HIV感染者的医疗记录。我们报告了诊断时的中位数和上80百分位数的CD 4（+）T淋巴细胞计数。结果：我们发现艾滋病定义条件首先发生在80%的诊断中CD 4（+）T淋巴细胞计数低于0.20 × 10（9）/L（200/μ L）的HIV感染患者中。同样，50%的诊断中，艾滋病定义疾病的发生率低于0.05x10（9）/L。符合两项标准的是浸润性宫颈癌和肺结核。80%的患者在CD 4（+）T淋巴细胞计数低于0.20X10（9）/L时被诊断为非艾滋病定义的疾病是细菌性脓毒症和视网膜病（不包括巨细胞病毒）。结论：我们的观察结果支持需要持续监测CD 4（+）细胞计数低于0.20X10（9）/L的水平，以指导HIV感染者的诊断和医疗管理。
Background: Depletion of circulating CD4(+) T lymphocytes among persons infected with the human immuno-deficiency virus (HIV) is associated with increased risk for development of opportunistic, life-threatening diseases and death.Methods: To describe the levels of CD4(+) T lymphocytes at which acquired immunodeficiency syndrome (AIDS)-defining and other illnesses initially occur, we analyzed data from an ongoing survey of medical records of 18 062 HIV-infected patients who received medical care between January 1990 and August 1993 in more than 100 clinics, hospitals, and private practices in 10 US cities. We report the median and upper 80th percentile CD4(+) T-lymphocyte counts at diagnosis.Results: We found that AIDS-defining conditions first occurred in HIV-infected patients with CD4(+) T-lymphocyte counts below 0.20 X10(9)/L (200/mu L) for 80% of diagnoses. Similarly, AIDS-defining diseases occurred at counts below 0.05x10(9)/L for 50% of diagnoses. Exceptions to both criteria were invasive cervical cancer and pulmonary tuberculosis. Non-AIDS-defining illnesses with which 80% of patients were diagnosed at CD4(+) T-lymphocyte counts below 0.20X10(9)/L were bacterial sepsis and retinopathy (excluding cytomegalovirus).Conclusion: Our observations support the need for continued CD4(+) cell count monitoring below a level of 0.20X10(9)/L as a guide to diagnosis and medical management of HIV-infected persons.