TY - JOUR
T1 - Predictors of survival in human immunodeficiency virus type 1-seropositive intravenous drug users
AU - Bryan Page, J.
AU - Lai, Shenghan
AU - Fletcher, Mary Ann
AU - Patarca, Roberto
AU - Smith, Prince C.
AU - Lai, Hong C.
AU - Klimas, Nancy G.
PY - 1996
Y1 - 1996
N2 - In an ongoing prospective study of street-recruited intravenous drug users (IDUs) in Miami, Fla., 116 human immunodeficiency virus type 1 (HIV-1)-infected IDUs were monitored for up to 7 years. This provided an opportunity to evaluate baseline immunological parameters as potential predictors of survival among HIV-1-infected IDUs. As expected, HIV-1-infected IDUs who had an advanced stage of the disease (Centers for Disease Control and Prevention classification III or IV); p24 antigenemia; human T-cell leukemia virus type 1/2 seropositivity; low CD4 counts (≤200); low hemoglobin (≤14), high serum immunoglobulin A (IgA) (>500 mg/dl), or high serum IgG (≥3,500 mg/dl) levels; or low proliferative responses to pokeweed mitogen (≤1,500 cpm) and to phytohemagglutinin (≤80,000 cpm) at baseline had worse survival rates. Results from multivariate Cox's models of survival showed that the baseline serum IgG level, serum IgA level, and CD4 count independently predict survival in HIV-1-infected IDUs. Cross-validation procedures verified the above-mentioned findings. These findings support the routine consideration of serum immunoglobulin levels in addition to CD4 count, especially in early evaluation of disease stage, as these evaluations may modify application of prophylaxis and treatment for HIV-1-infected IDUs. We recommend consideration of use of serum IgG and IgA as immunological markers for long-range prediction of survival in HIV-1-infected IDUs. These determinations are less onerous and more appropriate for use in field studies and financially less favored settings.
AB - In an ongoing prospective study of street-recruited intravenous drug users (IDUs) in Miami, Fla., 116 human immunodeficiency virus type 1 (HIV-1)-infected IDUs were monitored for up to 7 years. This provided an opportunity to evaluate baseline immunological parameters as potential predictors of survival among HIV-1-infected IDUs. As expected, HIV-1-infected IDUs who had an advanced stage of the disease (Centers for Disease Control and Prevention classification III or IV); p24 antigenemia; human T-cell leukemia virus type 1/2 seropositivity; low CD4 counts (≤200); low hemoglobin (≤14), high serum immunoglobulin A (IgA) (>500 mg/dl), or high serum IgG (≥3,500 mg/dl) levels; or low proliferative responses to pokeweed mitogen (≤1,500 cpm) and to phytohemagglutinin (≤80,000 cpm) at baseline had worse survival rates. Results from multivariate Cox's models of survival showed that the baseline serum IgG level, serum IgA level, and CD4 count independently predict survival in HIV-1-infected IDUs. Cross-validation procedures verified the above-mentioned findings. These findings support the routine consideration of serum immunoglobulin levels in addition to CD4 count, especially in early evaluation of disease stage, as these evaluations may modify application of prophylaxis and treatment for HIV-1-infected IDUs. We recommend consideration of use of serum IgG and IgA as immunological markers for long-range prediction of survival in HIV-1-infected IDUs. These determinations are less onerous and more appropriate for use in field studies and financially less favored settings.
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U2 - 10.1128/cdli.3.1.51-60.1996
DO - 10.1128/cdli.3.1.51-60.1996
M3 - Article
C2 - 8770504
AN - SCOPUS:19144365696
SN - 1071-412X
VL - 3
SP - 51
EP - 60
JO - Clinical and Diagnostic Laboratory Immunology
JF - Clinical and Diagnostic Laboratory Immunology
IS - 1
ER -