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- Document 2376
- DOCN M94A2376
- TI Quantitative measures of p24/gp41 and p24 HIV antibody as predictors of
- progression to AIDS: evidence for effect modification by zidovudine.
- DT 9412
- AU Strathdee SA; Frank J; Leblanc M; McLaughlin J; Major C; Le TN; Read SE;
- Dept. Prev. Med. & Biostat, U of Toronto, Canada.
- SO Int Conf AIDS. 1994 Aug 7-12;10(1):318 (abstract no. PC0204). Unique
- Identifier : AIDSLINE ICA10/94370199
- AB OBJECTIVE: To date, the manner in which HIV-specific antibody (Ab)
- levels are treated in statistical models has been generally
- non-quantitative. This study determined the potential of serial
- quantitative measures of HIV Ab as predictors of progression to AIDS in
- a cohort of homosexual men. METHODS: Reflectance densitometry was used
- to provide quantitative measures of HIV Ab from Western Blotting of
- serial serum specimens provided at quarterly intervals from 159 HIV+ men
- in the Toronto Sexual Contact Study, which observed 50 AIDS cases from
- '84-'91. Cox relative risk (RR) regression was used to predict risk of
- progression to AIDS, where HIV Ab and other laboratory markers were
- either fixed values at enrollment, or time-dependent covariates (TDC)
- which were continuously updated. Zidovudine (ZDV) and the presence of
- OIs were treated as binary TDC. Since the clinical relevance of HIV Ab
- was of primary interest, time was measured from enrollment. Ab levels
- were expressed in terms of optical density (OD x mm), as a ratio
- relative to the corresponding standard positive control, per 0.1 unit
- decline. RESULTS: Quantitative measures of p24 and p24/gp41 Ab ratio
- were independent predictors of progression. Both markers remained highly
- significant in multivariate models which treated Ab levels as fixed or
- TDC and controlled for the effects of other markers listed below. Final
- models considering TDC included either p24/gp41 Ab ratio (RR = 2.27, 95%
- CI: 1.01, 5.26) or p24 Ab (RR = 1.12, 95% CI: 1.01, 1.21), while
- controlling for CD4/CD8 ratio, age, OIs, and ZDV use (RR = 0.28, 95% CI:
- 0.11, 0.71). However, a significant time-dependent interaction was
- observed between ZDV use and p24 Ab, or ZDV and p24/gp41 Ab ratio,
- rendering the main effects non-significant. CONCLUSIONS: These data
- demonstrate that quantitative measures of p24 Ab and p24/gp41 Ab may be
- useful markers of future risk of progression to AIDS. Although these
- data are observational and should be interpreted with caution due to
- selection factors associated with ZDV use, these data suggest that the
- benefits provided by ZDV use are modest if levels of p24 Ab or p24/gp41
- Ab ratio are already declining. Such data could potentially be of use in
- clinical decision-making regarding ZDV therapy.
- DE Acquired Immunodeficiency Syndrome/DRUG THERAPY/*IMMUNOLOGY
- AIDS-Related Opportunistic Infections/IMMUNOLOGY Cohort Studies
- CD4-CD8 Ratio Homosexuality Human HIV Antibodies/*ANALYSIS HIV Core
- Protein p24/*IMMUNOLOGY HIV Envelope Protein gp41/*IMMUNOLOGY Male
- Zidovudine/*THERAPEUTIC USE MEETING ABSTRACT
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-