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M94A2382.TXT
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1994-10-25
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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
protected by Copyright Law (Title 17, U.S.Code).