PROGNOSTIC FACTORS IN HUMAN IMMUNODEFICIENCY VIRUS-POSITIVE PATIENTS WITH A CD4(+) LYMPHOCYTE COUNT LESS-THAN-50/MU-L

This analysis investigated variability of survival time in a cohort of 553 human immunodeficiency virus type 1 (HIV-1)-infected homosexual or bisexual men with <50 CD4(+) cells/mu L. Median survival after the first CD4(+) cell count <50/mu L was 1.34 years; 25% survived greater than or equal to 2 years. Multivariate analysis showed longer survival with concurrent acyclovir and zidovudine use, hemoglobin greater than or equal to 12 g/dL, and full-time employment (P < .0001). Other significant covariates associated with longer survival included African-American race, no prior AIDS illness, weight loss <4.5 kg, and zidovudine use (with or without concurrent acyclovir) after CD4(+) cells fell to <50/mu L. An easily derived score identified Multicenter AIDS Cohort Study subjects likely to survive >2 years after CD4(+) cell count was <50/mu L. Survival once CD4(+) cell count fell below 50/mu L may be longer for persons with a good performance status and specific clinical markers. Health care providers should consider these variables in decision-making strategies and design of clinical trials.