| Titre : | Predictive value of viral load and other markers for progression to clinical AIDS after CD4+cell count falls below 200/muL. (1998) |
| Auteurs : | N. CARRE ; F. BOUFASSA ; M. CHAVANCE ; C. GOUJARD ; J.B. HUBERT ; Y. LAURIAN ; L. Meyer ; C. ROUZIOUX ; Inserm U292. Le Kremlin Bicêtre. FRA ; Seroco & Hemoco Study Group. FRA |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 27, n° 5, 1998) |
| Pagination : | 897-903 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; Lymphocyte ; Plasma sanguin ; Epidémiologie ; Pronostic ; Homme ; France ; Europe ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST JR0xKjJf. Diffusion soumise à autorisation]. Background To assess the predictive value of biological and clinical events for progression to AIDS (1993 European classification) when the CD4+cell count falls below 200/muL (CD4 threshold) in different exposure groups. To investigate whether such markers remain predictive independently of the serum HIV-1 RNA level at the CD4 threshold. Methods The predictive value of biological and clinical events occurring during the 24 months prior to the occurrence of CD4 threshold (n=333) was quantified in a Cox model. Another Cox model was carried out in a subset of 77 patients in whom viral load from stored sera was available. Furthermore, changes in viral load during the 24 months preceding the CD4 threshold were assessed in a mixed model according to subsequent development of AIDS. Results Among the 333 patients, the slope of the CD4+cell counts, the emergence of p24 antigen, persistent thrush, and age at the CD4 threshold were independent predictors of progression to clinical AIDS (44.7%). Among the subset of 77 patients, the HIV-1 RNA level at the CD4 threshold, persistent thrush and age remained independent predictors of progression to AIDS (45.5%). The increase of the HIV-1 RNA level was moderate, both in non-progressors (24.0% per year) and in those who subsequently developed AIDS (27.1% per year), (P=0.93). Viral load was consistently higher in the latter group (P=0.002). (...) |
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