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1996-02-27
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Document 0235
DOCN M9630235
TI Herpes zoster, immunological deterioration and disease progression in
HIV-1 infection.
DT 9603
AU Veenstra J; Krol A; van Praag RM; Frissen PH; Schellekens PT; Lange JM;
Coutinho RA; van der Meer JT; Department of Public Health and
Environment, University of; Amsterdam, The Netherlands.
SO AIDS. 1995 Oct;9(10):1153-8. Unique Identifier : AIDSLINE MED/96098131
AB OBJECTIVE: To study the incidence of herpes zoster, the relationship
between herpes zoster and immunological markers, and the prognostic
value of herpes zoster for progression of HIV disease. DESIGN AND
METHODS: A total of 966 homosexual participants in The Amsterdam Cohort
Study were studied. Herpes zoster was defined by its characteristic
clinical presentation. Incidence was calculated using Poisson
regression, cumulative incidence by the Kaplan-Meier product-limit
method and the prognostic value was evaluated using Cox proportional
hazards model. RESULTS: The incidence of first episodes of herpes zoster
was 3.31 per 1000 person-years (PY) in HIV-seronegatives and 51.51 per
1000 PY in HIV-1-seropositive individuals. Recurrences only occurred in
HIV-1-positive patients (25.6%). Cumulative incidences of first episodes
increased linearly with the duration of follow-up. In
HIV-1-seropositives the incidence was 31.2 per 1000 PY at CD4+ cells >
or = 500 x 10(6)/l, 47.2 per 1000 PY [relative risk (RR), 1.51; 95%
confidence interval (CI), 0.78-2.94] at CD4+ cells 200-499 x 10(6)/l and
97.5 per 1000 PY (RR, 3.13; 95% CI, 1.54-6.32) at CD4+ cells < 200 x
10(6)/l. Besides CD4+ cell counts, CD3 monoclonal antibodies and
phytohaemagglutinin-induced T-cell reactivity were independent
predictors for herpes zoster. The hazard ratio for AIDS after herpes
zoster was 1.6 (95% CI, 1.1-2.4) and for death 1.7 (95% CI, 1.1-2.5),
but these were not independent from CD4+ cell counts. CONCLUSION: In
HIV-1 infection the incidence of herpes zoster increases with the
decrease of CD4+ cell counts and T-cell reactivity, but herpes zoster is
not an independent predictor for disease progression.
DE Adult Aged Antibodies, Monoclonal Biological Markers CD4 Lymphocyte
Count Disease Progression Herpes
Zoster/COMPLICATIONS/*EPIDEMIOLOGY/*IMMUNOLOGY Homosexuality, Male
Human HIV Seronegativity/IMMUNOLOGY HIV
Seropositivity/*COMPLICATIONS/IMMUNOLOGY *HIV-1 Incidence Male
Middle Age Prognosis Prospective Studies Recurrence Regression
Analysis Support, Non-U.S. Gov't T-Lymphocytes/IMMUNOLOGY JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).