Predictors of survival in human immunodeficiency virus type 1-seropositive intravenous drug users

J. Bryan Page, Shenghan Lai, Mary Ann Fletcher, Roberto Patarca, Prince C. Smith, Hong Chen Lai, Nancy G. Klimas

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)51-60
Number of pages10
JournalClinical and Diagnostic Laboratory Immunology
Volume3
Issue number1
StatePublished - 1996
Externally publishedYes

Fingerprint

Drug Users
Viruses
HIV-1
Survival
Pharmaceutical Preparations
CD4 Lymphocyte Count
Serum
Immunoglobulin A
Immunoglobulin G
Disease control
Deltaretrovirus
Pokeweed Mitogens
T-cells
Phytohemagglutinins
Centers for Disease Control and Prevention (U.S.)
Proportional Hazards Models
Immunoglobulins
Hemoglobins
Survival Rate
Prospective Studies

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Clinical Biochemistry
  • Immunology

Cite this

Predictors of survival in human immunodeficiency virus type 1-seropositive intravenous drug users. / Bryan Page, J.; Lai, Shenghan; Fletcher, Mary Ann; Patarca, Roberto; Smith, Prince C.; Lai, Hong Chen; Klimas, Nancy G.

In: Clinical and Diagnostic Laboratory Immunology, Vol. 3, No. 1, 1996, p. 51-60.

Research output: Contribution to journalArticle

Bryan Page, J. ; Lai, Shenghan ; Fletcher, Mary Ann ; Patarca, Roberto ; Smith, Prince C. ; Lai, Hong Chen ; Klimas, Nancy G. / Predictors of survival in human immunodeficiency virus type 1-seropositive intravenous drug users. In: Clinical and Diagnostic Laboratory Immunology. 1996 ; Vol. 3, No. 1. pp. 51-60.
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