Is the time from HIV seroconversion a determinant of the risk of AIDS after adjustment for updated CD4 cell counts?

被引：0

作者：

Babiker, A ^{[1
]}

Darbyshire, N ^{[1
]}

Pezzotti, P ^{[1
]}

Porter, K ^{[1
]}

Rezza, G ^{[1
]}

Walker, S ^{[1
]}

Beral, V ^{[1
]}

Coutinho, R ^{[1
]}

Del Amo, J ^{[1
]}

Gill, N ^{[1
]}

Lee, C ^{[1
]}

Meyer, L ^{[1
]}

Tyrer, F ^{[1
]}

Dabis, F ^{[1
]}

Thiebaut, R ^{[1
]}

Lawson-Ayayi, S ^{[1
]}

Meyer, L ^{[1
]}

Boufassa, F ^{[1
]}

Hamouda, O ^{[1
]}

Lorenzo, JI ^{[1
]}

Touloumi, G ^{[1
]}

Hatzakis, A ^{[1
]}

Karafoulidou, A ^{[1
]}

Katsarou, O ^{[1
]}

Brettle, R ^{[1
]}

del Romero, J ^{[1
]}

Prins, M ^{[1
]}

Coutinho, RA ^{[1
]}

van Benthem, B ^{[1
]}

Coutinho, RA ^{[1
]}

Kirk, O ^{[1
]}

Pedersen, C ^{[1
]}

Aguado, IH ^{[1
]}

Pérez-Hoyos, S ^{[1
]}

Eskild, A ^{[1
]}

Bruun, JN ^{[1
]}

Sannes, M ^{[1
]}

Sabin, C ^{[1
]}

Johnson, AM ^{[1
]}

Phillips, AN ^{[1
]}

Darbyshire, JH ^{[1
]}

Francioli, P ^{[1
]}

Vanhems, P ^{[1
]}

Egger, M ^{[1
]}

Rickenbach, M ^{[1
]}

Cooper, D ^{[1
]}

Kaldor, J ^{[1
]}

Vizzard, J ^{[1
]}

Tusell, JM ^{[1
]}

Ruiz, I ^{[1
]}

机构：

[1] MRC, Clin Trials Unit, London NW1 2DA, England

来源：

JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2001年 / 28卷 / 02期

关键词：

HIV; cohort; seroconverters; CD4; progression; AIDS;

D O I：

暂无

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To evaluate the effect of time from seroconversion to a (riven CD4 cell count on progression to AIDS after that count after adjusting for updated CD4 cell counts. Methods: Using pooled data from 19 seroconverter cohorts, we examined the association between the time from a CD4 < 500 cells/mm(3), (< 350, < 200) to the first AIDS-defining event and time from seroconversion to that CD4 threshold. We adjusted for age, gender, exposure category, and HIV test interval in Cox models stratified by cohort. We estimated the residual effect of time from seroconversion, adjusting for updated CD4 cell counts. A cause-specific competing-risks model was then used to evaluate this residual effect on progression to each AIDS-defining disease. Analyses were censored on December 31, 1995. Results: Of 3825, 3006, and 1804 individuals reaching CD4 thresholds of 500, 350, and 200, respectively, 1274, 1192, and 985, respectively, developed AIDS. We found a significant effect of time from seroconversion on the risk of AIDS even after adjusting for updated CD4 counts. For individuals reaching a CD4 threshold of 350 Cells/mm(3), a 1-year increase from seroconversion was associated with an increase in risk of AIDS of 6% (3%-9%) (p = .01). This effect appeared to be nonlinear. In the first 4 years, a 1-year increase from seroconversion was associated with an 11% increase in the risk of AIDS, but there was no apparent increase in risk after 4 years. The residual effect of time from seroconversion was significantly heterogeneous (p = .002), with respect to the risk of individual AIDS-defining diseases. Findings were similar for CD4 thresholds of 500 and 200 cells/mm3, respectively. Conclusions: We found a small, statistically significant, residual effect of time from seroconversion on the risk of AIDS. In practical terms, when considering an infected individual's risk of AIDS from a given CD4 cell count, there is little to be gained from knowing the time of seroconversion. However, this effect differs significantly among specific AIDS-defining diseases.

引用

页码：158 / 165

页数：8

共 50 条

[1] CD4 LYMPHOCYTE COUNT AS A DETERMINANT OF THE TIME FROM HIV SEROCONVERSION TO AIDS AND DEATH FROM AIDS - EVIDENCE FROM THE ITALIAN SEROCONVERSION STUDY
PHILLIPS, AN
PEZZOTTI, P
LEPRI, AC
REZZA, G
DORRUCCI, M
ALLIEGRO, B
SINICCO, A
MURATORI, S
TARANTINI, G
ANGARANO, G
LAZZARIN, A
AIUTI, E
ZACCARELLI, M
SALASSA, B
CASTELLI, F
VIALE, P
CANESSA, A
BARBANERA, M
RICCHI, E
ORTONA, L
PRISTERA, R
GAFA, S
TIRELLI, U
AIDS, 1994, 8 (09) : 1299 - 1305
[2] ASYMPTOMATIC BACTERIURIA IN HIV/AIDS PATIENTS: OCCURRENCE AND RISK ASSOCIATED WITH LOW CD4 COUNTS
Rashmi, K. S.
Ravikumar, K. L.
Jagadeesh
Nimitha
Bhagyashree, H. N.
JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS, 2013, 2 (19): : 3358 - 3366
[3] Higher risk of AIDS or death in patients with lower CD4 cell counts after virally suppressive HAART
Taiwo, B. O.
Li, X.
Palella, F.
Jacobson, L. P.
Margolick, J. B.
Detels, R.
Rinaldo, C. R.
Phair, J. P.
HIV MEDICINE, 2009, 10 (10) : 657 - 660
[4] Changes over time in post-seroconversion CD4 cell counts in the Italian HIV-seroconversion study: 1985-2002
Dorrucci, M
Phillips, AN
Longo, B
Rezza, G
AIDS, 2005, 19 (03) : 331 - 335
[5] Ten-year trends in CD4 cell counts at HIV and AIDS diagnosis in a London HIV clinic
Easterbrook, PJ
Yu, LM
Goetghebeur, E
Boag, F
McLean, K
Gazzard, B
AIDS, 2000, 14 (05) : 561 - 571
[6] Factors related to baseline CD4 cell counts in HIV/AIDS patients: comparison of poisson, generalized poisson and negative binomial regression models
Farhadian, Maryam
Mohammadi, Younes
Mirzaei, Mohammad
Shirmohammadi-Khorram, Nasrin
BMC RESEARCH NOTES, 2021, 14 (01)
[7] CD4 counts and the risk of systemic non-Hodgkin's lymphoma in individuals with HIV in the UK
Bower, Mark
Fisher, Martin
Hill, Teresa
Reeves, Iain
Walsh, John
Orkin, Chloe
Phillips, Andrew N.
Bansi, Loveleen
Gilson, Richard
Easterbrook, Philippa
Johnson, Margaret
Gazzard, Brian
Leen, Clifford
Pillay, Deenan
Schwenk, Achim
Anderson, Jane
Porter, Kholoud
Gompels, Mark
Sabin, Caroline A.
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2009, 94 (06): : 875 - 880
[8] Prediction of Health Preference Values from CD4 Counts in Individuals with HIV
Isogai, Pierre K.
Rueda, Sergio
Rachlis, Anita R.
Rourke, Sean B.
Mittmann, Nicole
MEDICAL DECISION MAKING, 2013, 33 (04) : 558 - 566
[9] Hematologic derangements in HIV/AIDS patients and their relationship with the CD4 counts: a cross-sectional study
Bhardwaj, Subhash
Almaeen, Abdulrahman
Wani, Farooq Ahmed
Thirunavukkarasu, Ashokkumar
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY, 2020, 13 (04): : 756 - 763
[10] A Model for the CD4 Cell Counts in an HIV/AIDS Patient and its Application in Treatment Interventions
Simwa, Richard O.
Mugisha, Joseph Y. T.
AMERICAN JOURNAL OF INFECTIOUS DISEASES, 2005, 1 (01) : 61 - 65

← 1 2 3 4 5 →