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1994-10-25
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Document 3042
DOCN M94A3042
TI Comparison of surrogate markers predictive for rapid progression of HIV
disease in patients with initial CD4 counts of 200 to 500.
DT 9412
AU Lange M; Klein EB; Inada Y; Maitra US; Mohan VP; St. Luke's-Roosevelt
Hosp. Ctr., Columbia University, NY, NY; 10025.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):167 (abstract no. PB0094). Unique
Identifier : AIDSLINE ICA10/94369533
AB OBJECTIVE: HIV positive patients with CD4 counts 200 to 500 are at
increased risk for AIDS. The optimal time to begin antiretroviral
therapy remains controversial. A reliable method to sort out rapid
progressors versus slow progressors could permit a more individualized
therapeutic approach. We previously reported on a significant
association between progressive HIV disease and elevated serum
acid-labile alpha interferon(AL-Ifn) levels together with reduced
erythrocyte complement 3b receptor binding activity (E-CR1 BA). We now
compared the relationship of these two markers to p24 Ag, immune complex
dissociated p24 Ag (ICD-p24) and dilutional plasma virus culture.
METHODS: 39 HIV positive patients with initial CD4 counts between 200
and 500 were recruited. Study surrogate markers were measured every 6 to
8 wks. 13 patients were followed for 24 wks and 26 patients were
followed for 50 to 58 wks. RESULTS: 7 patients demonstrated an AL-Ifn of
12 dilutional titer together with E-CR1 BA of zero percent. Of these,
one developed wasting syndrome, one lymphoma and another two showed
unidirectional rapid CD4 decline (150 over 6 months). In contrast, of
the remaining 32 patients with AL-Ifn 12, one became symptomatic. Of
these 6(19%) had positive p24 Ag, 17(53%) had positive ICD-p24 Ag and 18
(56%) had plasma viremia, whereas of the 7 with the Al-Ifn, 2(29%),
5(71%) and 4(57%) had the above markers respectively. CONCLUSIONS: The
combination of positive serum AL-Ifn with low E-CR1 BA predicted
clinical illness and CD4 decline more accurately than the virologic
markers tested. Differential therapies maybe warranted for patients with
CD4 200-500 demonstrating AL-Ifn and decreased E-CR1 binding activity.
DE Acquired Immunodeficiency Syndrome/DIAGNOSIS/IMMUNOLOGY Biological
Markers/*BLOOD Comparative Study Follow-Up Studies Human HIV Core
Protein p24/BLOOD HIV Infections/DIAGNOSIS/*IMMUNOLOGY HIV
Seropositivity/DIAGNOSIS/IMMUNOLOGY Interferon-alpha/BLOOD *Leukocyte
Count Receptors, Complement 3b/METABOLISM T4 Lymphocytes/*IMMUNOLOGY
Virus Cultivation MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).