Document 2382
 DOCN  M94A2382
 TI    Long-term survival in patients with advanced immunodeficiency.
 DT    9412
 AU    Chene G; Easterbrook PJ; Jusczak E; Yu LM; Pocock S; Gazzard BG; Chelsea
       and Westminster Hospital, London, U.K.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):317 (abstract no. PC0198). Unique
       Identifier : AIDSLINE ICA10/94370193
 AB    OBJECTIVE: To determine clinical and laboratory factors associated with
       long-term survival in patients with advanced immunodeficiency (i.e. at
       least one CD4 count < or = 50 cells/mm3). METHODS: 1214 HIV-1 infected
       patients were followed from their first CD4 cell count less than 50
       (CD50) for a median of 12 months (range 1-80). Their survival
       probabilities at 1, 2 and 3 years were 67%, 30% and 13%, respectively.
       Using a nested case-control approach, long-term survivors (LTS) were
       defined as those who survived for more than 3 years from CD50 (n = 55),
       and compared with two other groups: short-term survivors (STS) who died
       within 1 year of CD50 (n = 365), and medium-term survivors (MTS) who
       died within 1-3 years of CD50 (n = 417). Clinical status, laboratory
       measurements and use of antiretroviral therapy and PCP prophylaxis
       during the course of disease and at CD50 were compared between these
       groups. RESULTS: Compared to STS and MTS, at CD50, LTS were younger (39,
       37, 33 yrs, respectively, p < 0.0001), had higher CD4 and haemoglobin
       values (27, 31, 34 cells/mm3; 11, 12, 13 g/dl, p < 0.0001), and were
       less likely to have a prior AIDS diagnosis (35, 61, 72%, p < 0.0001).
       LTS also had a significantly slower rate of CD4 decline (-51, -35, -22
       cells/6 mth, p < 0.0001) and a higher CD4 cell count up to 18 months
       prior to CD50 (209, 214, 332 cells, p < 0.0001). There were no
       significant differences between the groups in gender, risk group,
       duration of HIV infection, year of CD50, prior use of antiretroviral
       therapy or PCP prophylaxis. CONCLUSION: A small proportion (13%) of HIV
       infected persons with low CD4 counts survive for more than 3 years. Our
       findings indicate that in addition to factors present at CD50, LTSs can
       be distinguished by their CD4 profile many months prior to CD50.
 DE    Adult  Age Factors  Hemoglobins/ANALYSIS  Human  HIV Infections/DRUG
       THERAPY/IMMUNOLOGY/*MORTALITY  Leukocyte Count  Risk Factors  Survival
       Rate  T4 Lymphocytes  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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