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Document 3092
DOCN M94A3092
TI Prognostic value of HIV-1 biological phenotype for survival after AIDS
diagnosis.
DT 9412
AU Koot M; van Leeuwen R; Danner S; Schuitemaker H; Tersmette M; Reis P;
Central Lab. Blood Transf., Amsterdam, The Netherlands.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):155 (abstract no. PB0046). Unique
Identifier : AIDSLINE ICA10/94369483
AB In about 50% of HIV-1 infected persons syncytium inducing (SI) HIV-1
variants emerge during the asymptomatic phase of infection. The presence
of SI variants in asymptomatic men is predictive for the progression to
AIDS, independent of CD4+ T-cell numbers. Here we studied survival among
AIDS patients in relation to HIV-1 phenotype CD4+ T-cell counts, and P24
antigenemia. METHODS: In this study we included all AIDS patients (n =
218) who were diagnosed at the Academic Medical Centre between 1
December 1985 and 1 December 1989. HIV-1 phenotype was determined by
cocultivation of cryopreserved PBMC samples with MT-2 cells. RESULTS:
Median CD4 count at the moment of AIDS diagnosis was 100/mm3. From 178
out of 218 patients (82%) PBMC samples were available. In 89/178 persons
(50.0%) SI HIV was detected. There was no significant difference between
the patients with and without SI variants with respect to the number of
P24 antigen positive persons or the number of zidovudine treated
persons. However CD4 counts at the time of AIDS diagnosis were
significantly lower in persons with SI variants (median: 100/mm3 vs.
200/mm3, p = 0.003). Zidovudine treatment, low CD4 counts and the
presence of SI HIV-1 were predictive for decreased survival time in
univariate cox analysis. Multivariate Cox analysis revealed prognostic
value for zidovudine treatment and low CD4 counts only. Most (29/30)
patients without SI HIV at AIDS diagnosis did not develop these variants
during the final stage of disease. CONCLUSIONS: In agreement with
previous published results about 50% of patients progressing to AIDS
harbour SI viruses. These patients have significant lower CD4 counts at
AIDS diagnosis. In this study population of AIDS patients the prognostic
value of SI phenotype for survival could be explained by the association
of SI variants with low CD4 counts at the moment of AIDS diagnosis.
Emerge of SI variants after AIDS diagnosis was rarely observed even when
the immune system is severely deteriorated.
DE Acquired Immunodeficiency Syndrome/DRUG THERAPY/*MICROBIOLOGY/
*MORTALITY Analysis of Variance Cell Line Comparative Study Human
HIV Core Protein p24/BLOOD HIV Seropositivity/DRUG
THERAPY/*MICROBIOLOGY/MORTALITY HIV-1/*GENETICS/ISOLATION & PURIF
Leukocyte Count Lymphocytes/IMMUNOLOGY/MICROBIOLOGY Multivariate
Analysis Phenotype Predictive Value of Tests Prognosis Survival Rate
T4 Lymphocytes Zidovudine/THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).