WITHIN-SUBJECT VARIATION IN CD4 LYMPHOCYTE COUNT IN ASYMPTOMATIC HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - IMPLICATIONS FOR PATIENT MONITORING
WITHIN-SUBJECT VARIATION IN CD4 LYMPHOCYTE COUNT IN ASYMPTOMATIC HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - IMPLICATIONS FOR PATIENT MONITORING
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DOI：
10.1093/infdis/169.1.28
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发表时间：
1994-01-01
影响因子：
6.4
通讯作者：
VOLBERDING, PA
中科院分区：
文献类型：
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作者：
HUGHES, MD;STEIN, DS;VOLBERDING, PA
CD4 淋巴细胞计数的变化广泛用于监测人类免疫缺陷病毒 (HIV) 感染患者的疾病进展。然而，随机波动可能会掩盖临床上显着的变化。对 1020 名未经治疗的无症状 HIV 感染受试者的 CD4 细胞计数进行了评估，这些受试者通过标准化方法进行了长达 2 年的监测。受试者内变异系数平均为 25%，但在计数较低的受试者中更高； 6% 的受试者的计数是 8 周前的一半或两倍。下降比例与基线计数的相关性可以忽略不计，平均每年为 14.3%，但受试者之间差异很大：估计有 29% 有上升趋势。 HIV p24 阳性受试者以及淋巴细胞百分比较高或血小板计数或血红蛋白水平较低的受试者的下降幅度更大。由于变异如此之大，应谨慎解释单个计数之间的变化。使用多次计数和其他标记可以提供更精确的免疫状态评估。
Changes in CD4 lymphocyte counts are widely used in monitoring human immunodeficiency virus (HIV)-infected patients for disease progression. However, random fluctuations may obscure clinically significant changes. CD4 cell counts from 1020 untreated subjects with asymptomatic HIV infection monitored by standardized methods for up to 2 years were assessed. The within-subject coefficient of variation averaged 25% but was higher in subjects with lower counts; in 6% of subjects the count was half or double the one obtained 8 weeks before. Proportionate rates of decline, which had negligible correlation with the baseline count, averaged 14.3%/year but varied considerably between subjects: An estimated 29% had increasing trends. Declines were greater in HIV p24-positive subjects and those with higher lymphocyte percentages or lower platelet counts or hemoglobin levels. With such high variation, changes between single counts should be interpreted cautiously. Using multiple counts and other markers may provide more precise assessment of immune status.