CD4 Lymphocyte Decline and Survival in Human Immunodeficiency Virus Infection
Abstract
The loss of the CD4 lymphocyte is the central pathophysiologic event in the progression of human immunodeficiency virus infection. This retrospective study, based on review of data from decreased HIV patients followed in a single HIV clinic, was conducted to determine if the rate of CD4 lymphocyte decline was predictive of survival. Forty of 172 patients met defined criteria for inclusion in this study. For each patient, CD4-cell counts showed approximate exponential decline over time. A cox regression analysis was used to assess the association of CD4 cell decline, race, age, gender, initial CD4-cell count, and treatment on total survival and on remaining survival time after reaching a CD4 cell count of 100. For all patients, the rate of CD4 cell decline was predictive of total survival but not for survival after reaching a count of 100. For patients who had never received therapy, however, the CD4 half-life remained associated with survival time from 100 CD4 cells as opposed to the treated patients. Therapy was the single variable most predictive of both survival endpoints, resulting in an increase in median total survival of 27.2 mo and of 15.4 mo from a cell count 100. Nonwhites had a slight survival disadvantage compared to whites. It was concluded that in the natural history of HIV infection, the rate of CD4 cell decline is predictive of total survival.... HIV Infection, CD4 Lymphocyte.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 1992
- Accession Number
- ADA259399
Entities
People
- Douglas B. Tang
- Joseph J. Drabick
- Raymond C. Chung
- Wellington Sun
- Wheaton J. Williams
Organizations
- Walter Reed Army Institute of Research